Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Key clinical features suggesting a diagnosis of Paget's disease of bone include:
- Bone pain, which is often the most common presenting symptom and may be localized or diffuse.
- Bone deformities such as bowing of long bones or skull enlargement, reflecting abnormal bone remodeling.
- Increased warmth over affected bones due to increased vascularity.
- Pathological fractures occurring with minimal trauma, indicating weakened bone structure.
- Neurological symptoms such as hearing loss or nerve compression syndromes if the skull or spine is involved.
- Asymptomatic cases detected incidentally by elevated serum alkaline phosphatase or characteristic radiological findings.
These features arise from the focal areas of increased and disorganized bone turnover characteristic of Paget's disease, which can affect one or multiple bones. Diagnosis is supported by biochemical markers and imaging but clinical suspicion is raised primarily by the above signs and symptoms.
Tan & Ralston 2014Lalam et al. 2016Gennari et al. 2019NICE CKS
Key References
- CKS - Osteoporosis - prevention of fragility fractures
- NG132 - Hyperparathyroidism (primary): diagnosis, assessment and initial management
- NG219 - Gout: diagnosis and management
- NG12 - Suspected cancer: recognition and referral
- (Tan and Ralston, 2014): Paget's disease of bone.
- (Lalam et al., 2016): Paget Disease of Bone.
- (Gennari et al., 2019): Paget's Disease of Bone.