Paget's Disease and ArthritisWhat is Paget's Disease of Bone?First, some information about bone and the effects of arthritis and Paget's Disease on healthy bone. Bone is not just a lump of calcified matter that is inanimate and unfeeling. You only need to knock your elbow or bark your shin to realise that bone can transmit pain. Ostoarthritis is usually the result of degenerative wear and tear over a long period of time but Paget's disease can also be a cause, where it occurs near a joint. Paget's Disease was named after Sir James Paget, who was a surgeon at St Bartholomew's Hospital, in London in the late 19th century. He wrote an early and very clear description of this disease and it now bears his name. Paget's disease is not rare.
Where symptoms do occur, pain in the bone and in adjacent joints will be most likely, probably as a result of arthritis, which may be caused by the deformation of the bone or may already be present as a result of normal wear and tear in an older person. As a result of the disorganised cell activity, the bone expands and may cause deformity. Any bone in the skeleton can be affected but the most common are the pelvic bones, the spine, the thigh bone (the femur) and the shin (tibia). Paget's disease affects more men than women, by a ratio of 3 to 2. Bone is an active tissue, made up of three components: 1) Mineral which is mainly calcium; Bone, in common with most cells in the body, is constantly changing, deteorating and being renewed. "Old" bone is continually removed by the action of osteoclast cells and replaced by new bone, made by ostoblast cells. This turnover and renewal of bone is carefully balanced but Paget's Disease upsets this balance and interferes with the timing of the two functions. Paget's disease affects the growth of the bone, by causing abnormality in the bone cells. The regular, ordered process of bone loss and renewal is disrupted and doesn't take place properly. Instead, the bone cells increase in number, sometimes very rapidly and become larger and also more active. Bone turnover increases by up to 40 times, so it is not surprising that the new bone that is made is disorganised, abnormal in shape and weaker than usual. The increased activity of the bone cells also increases the blood flow through the bone. If a bone affected by Paget's is close to the skin, like a shin bone, it can feel warm to the touch. I have Paget's in my left tibia (shin bone) which affects my left knee, so I regular check my leg for signs of "hotting up". I am also in line for a precautionary blood test every six months.
Diagnosis of Paget's Disease. In my own case, the condition was spotted as a result of a routine x-ray for worsening arthritis of my knees. This is a common occurrence, where the existence of Paget's disease is discovered by accident on an x-ray which has been asked for for a quite different purpose. The specialist ordered a nuclear medicine examination, to make a closer examination of both legs. In fact, my whole body was scanned, also revealing extensive arthritis in my lumbar spine. A radioactive isotope is injected into a vein and several hours later, the scan is performed. The Paget's disease in my knee was deemed to be not active and no treatment was immediately necessary. As a precautionary measure, a blood test will be taken every six months to determine any change in the activity of the condition. The blood test is an easy way to detect the disease and also to monitor its progress. The isotope is taken up into bone but is much more readily taken up by areas affected by Paget's disease. The scan then detects the level of radioactivity coming from each bone. High levels of radioactivity are found in the bones affected by the disease. Patients are advised to avoid close contact with pregnant women and young children for at least 24 hours after the injection. Find further comprehensive information at Paget's Disease Treatment The best source for further general information is: The National Association for the Relief of Paget's Disease
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