Paget's Disease of Bone - Associated Medical Conditions

Associated Medical Conditions

Paget's disease may lead to other medical conditions, including:

• Arthritis may be caused by bowing of long bones in the leg, distorting alignment and increasing pressure on nearby joints. In addition, pagetic bone may enlarge, causing joint surfaces to undergo excessive wear. In these cases, pain may be due to a combination of Paget's disease and osteoarthritis.
• Loss of hearing in one or both ears may occur when Paget's disease affects the skull and the bone that surrounds the inner ear. Treating the Paget's disease may slow or stop hearing loss. Hearing aids may also help.
• Cardiovascular disease can result from severe Paget's disease (i.e. with more than 15% skeletal involvement). Arteriovenous connections can often form in the bone, and so the heart has to work harder (pump more blood) to ensure adequate oxygen supply to the tissues. This increase in cardiac output can lead to calcification of the aortic valve, and the resulting aortic stenosis causes left ventricular hypertrophy and eventually high-output congestive failure.
• Kidney stones are somewhat more common in patients with Paget's disease.
• Pagetic bone can cause nervous system problems, such as pressure on the brain, spinal cord, or nerves, and reduced blood flow to the brain and spinal cord.
• Rarely, Paget's disease is associated with the development of osteosarcoma (malignant tumor of bone). When there is a sudden onset or worsening of pain, sarcoma should be considered.
• When Paget's disease affects the facial bones, the teeth may become loose. Disturbance in chewing may occur.
• Rarely, when the skull is involved, the nerves to the eye may be affected, causing some loss of vision.
• Angioid streaks may develop, possibly as a result of calcification of collagen or other pathological deposition.

Paget's disease is not associated with osteoporosis. Although Paget's disease and osteoporosis can occur in the same patient, they are different disorders. Despite their marked differences, several treatments for Paget's disease are also used to treat osteoporosis.