Paget’s Disease of Bone: Orthopedic Management

  • A. G. Hadjipavlou
  • P. H. Lander
  • I. P. Enker
Conference paper

Abstract

Paget’s disease of bone is a peculiar disorder of the bone modeling and remodeling processes. It is a relatively common condition after 45 years of age. While often an incidental finding on roentgenograms, it can be symptomatic and crippling, characterized by bone deformities, arthropathy, pathologic fractures, malignant transformation, cranial nerve compression, spinal stenosis, and back pain syndrome. Cranial nerve compression will not be dealt with in this review.

Keywords

Arthritis Immobilization Sarcoma Osteogenic Sarcoma Calcitonin 

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References

  1. 1.
    Altman, R.D.: Musculoskeletal complications of Paget’s disease of bone. Arthritis Rheum. 23, 1121, 1980.PubMedCrossRefGoogle Scholar
  2. 2.
    Barry, H.C.: Fractures in the femur in Paget’s disease of bone in Australia. J. Bone Joint Surg. 49A, 1359, 1967.PubMedGoogle Scholar
  3. 3.
    Barry, H.C.: Paget’s Disease of Bone. E.S. Livingstone, Ltd., Edinburgh and London, 1969.Google Scholar
  4. 4.
    Beyer, U., and Paul, D.: Frakturen bei Ostitis Deformans Paget. Zentralblatt für Chirurgie 97, 470, 1972.PubMedGoogle Scholar
  5. 5.
    Bird, C.E.: Sarcoma complicating Paget’s disease of the bone. Arch. Surg. 14, 1187, 1927.Google Scholar
  6. 6.
    Bombelli, R.: Osteoarthritis of the Hip. 2nd Ed., Springer Verlag, New York, 1983. p. 8.Google Scholar
  7. 7.
    Boudreau, R.J., Lisbona, R., and Hadjipavlou, A.: Observation of serial radionuclide blood flow studies in Paget’s disease. J. Nucl. Med. 24, 880, 1983.PubMedGoogle Scholar
  8. 8.
    Brailsford, J.F.: Paget’s disease of bone. Its frequency, diagnosis and complications. Br. J. Radiol. 128, 507, 1938.CrossRefGoogle Scholar
  9. 9.
    Burgeuer, F.A., and Perry, P.E.: Solitary renal cell carcinoma metastasis in Paget’s disease simulating sarcomatous degeneration. AJR 128, 843, 1977.Google Scholar
  10. 10.
    Camp, J.D.: Sarcoma complicating osteitis deformans: A case report of two cases. Radiology 5, 495, 1925.Google Scholar
  11. 11.
    Choquette, D., Heraoui, B., Altman, D., and Pelletier, J.P.: Simultaneous multifocal sarcomatous degeneration in Paget’s disease of bone. Clin. Orthop. 179, 308, 1983.PubMedCrossRefGoogle Scholar
  12. 12.
    Coley, B.L. and Sharp, G.S.: Paget’s disease predisposing factor to osteogenic sarcoma. Arch. Surg. 23, 918, 1931.Google Scholar
  13. 13.
    Davie, T.B. and Cooke, W.E.: Supervention of osteogenic sarcoma in Paget’s disease. Br. J. Surg. 25, 299, 1937.CrossRefGoogle Scholar
  14. 14.
    Dickson, D.D., Camp, J.D., and Ghormley, R.K.: Osteitis deformans, Paget’s disease of bone. Radiology 44, 449, 1945.Google Scholar
  15. 15.
    Douglas, D.I., Duckworth, T., Kanis, J.A., Jefferson, A.A., Martin, J.G., and Rüssel, R.G.: Spinal cord dysfunction in Paget’s disease of bone. Has medical treatment a vascular basis. J. Bone Joint Surg. 63B, 495, 1981.Google Scholar
  16. 16.
    Dove, J.: Complete fractures of the femur in Paget’s disease of bone. J. Bone Joint Surg. 62B, 12, 1980.Google Scholar
  17. 17.
    Dorwart, R.H.: Fundamentals of the computed tomographic assessment of spinal stenosis. In, Spine Update, 1984. Perspective in Radiology, Orthopedic Surgery and Neurosurgery. Radiology Research and Education Foundation, 181, 1983.Google Scholar
  18. 18.
    Dorwart, R.H., Volger, J.B. III, and Helms, C.A.: Spinal stenosis. Radiol. Clin. North Am. 21, 301, 1983.PubMedGoogle Scholar
  19. 19.
    Epstein, L.T., Bixler, D., and Bennett, J.E.: An incidence of familial cancer including three cases of osteogenic sarcoma. Cancer 25, 889, 1970.PubMedCrossRefGoogle Scholar
  20. 20.
    Frank, A.W., Bress, N.M., Singer, F.R., and Krane, S.M.: Rheumatic manifestations of Paget’s disease of bone. Am. J. Med. 56, 592, 1974.CrossRefGoogle Scholar
  21. 21.
    Freydinger, J.E., Dubig, J.T., and McDonald,: I.: Sarcoma complicating Paget’s disease of bone. Arch. Pathol. Lab. Med. 75, 496, 1963.Google Scholar
  22. 22.
    Frost, H.M.: Bone Remodeling and Skeletal Modeling Errors. Orthopaedic Lectures, Vol. IV. Charles Thomas, Springfield, 1973.Google Scholar
  23. 23.
    Goldman, A.B., Bullough, P., Kammeron, S., and Ambos, M.; Osteitis deformans of the hip joint. AJR 128, 601, 1977.PubMedGoogle Scholar
  24. 24.
    Greditzer, H.G., McLeod, R.A., Unni, K.K., and Beabout, J.W.: Bone sarcomas in Paget’s disease. Radiology 146, 327, 1983.PubMedGoogle Scholar
  25. 25.
    Grundy, M.: Fractures of the femur in Paget’s disease of bone. Their etiology and treatment. J. Bone Joint Surg. 52B, 252, 1970.Google Scholar
  26. 26.
    Guyer, P.B., and Dewbury, K.C.: The hip joint in Paget’s disease (Paget’s coxopathy). Br. J. Radiol. 51, 574, 1978.PubMedCrossRefGoogle Scholar
  27. 27.
    Hadjipavlou, A., and Lander, P.: Unusual radiological manifestations and a dynamic classification of Paget’s disease of bone. J. Bone Joint Surg. 64B, 258, 1982.Google Scholar
  28. 28.
    Hadjipavlou, A., Lisbona, R., and Boudreau, R.: Radionuclide bone blood flow in Paget’s disease of bone. Orthopaedic Transactions. J. Bone Joint Surg. 8, 215, 1984.Google Scholar
  29. 29.
    Hadjipavlou, A., Tsoukas, G.M., Siller, T.N., Danais, S., and Greenwood, F.: Combination of drug therapy in treatment of Paget’s disease of bone. J. Bone Joint Surg. 59A, 1045, 1977.PubMedGoogle Scholar
  30. 30.
    Hadjipavlou, A., and Zucker, J.: Sarcoma in Paget’s disease of bone. In, Current Concepts of Diagnosis and Treatment of Bone and Soft Tissue Tumors. Eds: Uhthoff, H.-K., and Stahl, E.: Springer Verlag, Berlin-Heidelberg, 1983. pp 383–394.Google Scholar
  31. 31.
    Hartman, J.TV and Dohn, D.F.: Paget’s disease of the spine with cord or nerve root compression. J. Bone Joint Surg. 48A, 1079, 1966.PubMedGoogle Scholar
  32. 32.
    Huvos, G.A., Butler, A., and Bretsky, S.: Osteogenic sarcoma associated with Paget’s disease of bone. Cancer 52, 1489, 1983.PubMedCrossRefGoogle Scholar
  33. 33.
    Jaffe, H.: Paget’s disease of bone. Arch. Pathol. 15, 83, 1933.Google Scholar
  34. 34.
    Johnston, C.C., Altman, R.D., Canfield, R.E., Finerman, A.G., and Taul-bee, J.D.: Review of fracture experience during treatment of Paget’s disease of bone with etidronate disodium (EHDP). Clin. Orthop. 172, 183, 1983.Google Scholar
  35. 35.
    Krane, S.M.: Etidronate disodium in the treatment of Paget’s disease of bone. Ann. Intern. Med. 96, 619, 1982.PubMedGoogle Scholar
  36. 36.
    Lake, M.: Studies of Paget’s disease (osteitis deformans). J. Bone Joint Surg. 33B, 323, 1951.Google Scholar
  37. 37.
    Lake, M.: The pathology of fracture in Paget’s disease. Aust. NZ J. Surg. 27 307, 1958.CrossRefGoogle Scholar
  38. 38.
    Lemaire, R.: Les fractures des os longs dans la maladie de Paget. Acta Orthop. Belg. 40, 4, 1974.Google Scholar
  39. 39.
    Lowry, A.M., and Rutherford, J.L.: Osteitis deformans (Paget’s disease) fissure fractures - Their etiology and clinical significance. AJR 38, 109, 1937.Google Scholar
  40. 40.
    Mathé, J.F., Delobel, R., Resche, F., Cler, J.M., and Feve, J.R.: Syndrome medullaires au cours de la maladie de Paget. Rôle du facteur vasculaire. La Nouv. Presse Med. 39, 2619, 1976.Google Scholar
  41. 41.
    McKenna, R.J., Schwinn, C.P., Soong, K.Y., and Higinbotham, N.L.: Osteogenic sarcoma arising in Paget’s disease. Cancer 17, 42, 1964.PubMedCrossRefGoogle Scholar
  42. 42.
    Merkow, R.L., and Lane, J.M.: Current concepts of Paget’s disease of bone. Orthop. Clin. North Am. 15, 747, 1984.PubMedGoogle Scholar
  43. 43.
    Meyers, M.H., and Singer, F.R.: Osteotomy for tibia vara in Paget’s disease under cover of calcitonin. J. Bone Joint Surg. 60A, 810, 1977.Google Scholar
  44. 44.
    Milgram, J.W.: Orthopaedic management of Paget’s disease of bone. Clin. Orthop. 127, 63, 1977.PubMedGoogle Scholar
  45. 45.
    Molle, D., Bord, H., Kuntz, D., Voisin, C., Farcet, J.P., Delepine, D., and Rychewaert, A.: Ostelyse rélévatrice d’un lymphome développé. Rev. Rhum. Mal. Osteoartic. 50, 217, 1983.PubMedGoogle Scholar
  46. 46.
    O’Reilly, T.J., and Race, J.: Osteitis deformans. Q. J. Med. 12, 471, 1932.Google Scholar
  47. 47.
    Paget, J.: Remarks on osteitis deformans. Illust. Med. News. 2, 181, 1889.Google Scholar
  48. 48.
    Piatt, H.: Sarcoma in abnormal bones. Br. J. Surg. 34, 232, 1947.CrossRefGoogle Scholar
  49. 49.
    Poretta, C.A., Dablin, D.C., and Jones, J.M.: Sarcoma in Paget’s disease of bone. J. Bone Joint Surg. 39A, 1314, 1957.Google Scholar
  50. 50.
    Price, C.H.G., and Goldie, W.: Paget’s sarcoma of bone. A study of eighty cases from the Bristol and Leeds Bone Tumor Registries. J. Bone Joint Surg. 51B, 205, 1969.Google Scholar
  51. 51.
    Rauis, A.: Étude statistique sur la maladie de Paget, ses complications et leur traitement. Acta Orthop. Belg. 40, 4, 1974.Google Scholar
  52. 52.
    Redden, J.F., Dixon, J., Vennart, W., and Hoskins, D.J.: Management of fissure fractures in Paget’s disease. Int. Orthop. 5, 103, 1981.PubMedCrossRefGoogle Scholar
  53. 53.
    Resnick, D., and Niwayáma, G.: Diagnosis of Bone and Joint Disorders with Emphasis on Articular Abnormalities. W.B. Saunders, Philadelphia, 1981. p. 1738.Google Scholar
  54. 54.
    Roberts, R.EV and Cohen, M.J.: Osteitis deformans (Paget’s disease of bone). Proc. Royal Soc. Lond. 19, 13, 1926.Google Scholar
  55. 55.
    Rogers, M.H., and Ulin, R.: Fractures in Paget’s disease. J. Bone Joint Surg. 18, 914, 1936.Google Scholar
  56. 56.
    Ryan, W.C., and Schwartz, T.B.: Mithramycin and malignancy (Letter). Ann. Int. Med. 9279, 1981.Google Scholar
  57. 57.
    Schatzki, S.CV and Dudley, H.R.: Bone sarcoma complicating Paget’s disease. Cancer 14, 517, 1961.PubMedCrossRefGoogle Scholar
  58. 58.
    Siegelman, S.S., Levine, S.A., and Walpin, L.: Paget’s disease with spinal cord compression. Clin. Radiol. 19, 421, 1968.PubMedCrossRefGoogle Scholar
  59. 59.
    Singer, R.F.: Paget’s disease of bone. Topics in Bone and Mineral Disorders Series. Ed: Avioli, L.V., Plenum Publishing Corporation, 1977. p. 112.Google Scholar
  60. 60.
    Smidek, H.H.: Neurologic and neurosurgical sequelae of Paget’s disease of bone. Clin. Orthop. 127, 70, 1977.Google Scholar
  61. 61.
    Smith, J., Botel, F.J., and Yeh, S.D.J.: Bone sarcomas in Paget’s disease: A study of 85 patients. Radiology 152, 583, 1984.PubMedGoogle Scholar
  62. 62.
    Sumney, T.JV and Pressley, C.L.: Sarcoma complicating Paget’s disease of bone. Ann. Surg. 123, 135, 1946.CrossRefGoogle Scholar
  63. 63.
    Weisz, G.M.: Lumbar spinal canal stenosis in Paget’s disease. Spine 8, 192, 1983.PubMedCrossRefGoogle Scholar
  64. 64.
    Wick, M.R., Siegel, G.P., Unni, K.K., McLeod, R.A., and Greditzer, H.G.: Sarcomas of bone complicating osteitis deformans (Paget’s disease). Fifty years experience. Am. J. Surg. Pathol. 5, 47, 1981.PubMedCrossRefGoogle Scholar
  65. 65.
    Zlatkin, B.M., Lander, P.H., Levine, J.H., and Hadjipavlou, A.: Computed tomography of Paget’s disease of the spine. Presented at the 48th Annual Meeting of the Canadian Association of Radiologists, Toronto, Canada. June, 1985 - in program.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • A. G. Hadjipavlou
  • P. H. Lander
  • I. P. Enker

There are no affiliations available

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