Information for you and your patient 

Scroll for information or download our ‘Paget’s Essential Facts’ leaflet below for your patient.  Our booklet ‘Information for Health Professionals’ includes aetiology, diagnosis, treatment and case histories and can be downloaded below.

Assessment 

When Paget’s Disease of Bone (PDB) is suspected, there must be a detailed assessment process, including any family history of the condition. 

Clinical Features 

• In those that present clinically, bone pain is the most common symptom. 
• The blood flow to active areas of Paget’s disease increases due to the high rate of bone remodelling. This can sometimes lead to a feeling of warmth over the affected bone. 

• The affected bone may become enlarged and misshapen. 
  

Diagnosis 

• Serum total alkaline phosphatase (ALP), is typically (not always) elevated in active PDB.  

• Characteristic features on x-ray (summarised below).  
• Radionuclide bone scintigraphy for diagnosis and to assess the extent of the disease. 

X-ray features of PDB
- Osteolytic areas
- Cortical thickening
- Loss of distinction between cortex and medulla
- Trabecular thickening
- Osteosclerosis
- Bone expansion
- Bone deformity

Referral 

Most UK hospitals have a specialist who can deal with the condition (often in a metabolic bone clinic or rheumatology). If there is no specialist locally, then referral to one of the Paget’s Association Centres of Excellence might be beneficial.  

Next, find out about management using the link below