Materiały źródłowe

• #1 Paget’s disease – Nurses Revision

  https://nursesrevisionuganda.com/pagets-disease/

  Pagets disease of bone also known as osteitis deformans is a chronic disease of the skeleton characterized by focal excessive bone remodeling. and is the second most common bone disease worldwide after osteoporosis. […] Pagets disease of bone is a disorder in which theres a lot of bone remodeling that happens in some regions of the bone. Typically theres excessive bone resorption followed by excessive bone growth, and that leads to skeletal deformities and potential fractures. […] There is no cure for Pagets disease and no way to reverse its effects on bone. […] Aims; To relieve bone pain and prevent the progression of the disease […] Treatment focuses on the relief of symptoms […] Prevention of future complications. […] Non-pharmacological Therapy. Physical therapy for the improvement of muscle strength and pain relief in some types of pain.

• #1 Paget’s disease of bone – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pagets-disease-of-bone/symptoms-causes/syc-20350811

  Paget’s (PAJ-its) disease of bone interferes with your body’s normal recycling process, in which new bone tissue gradually replaces old bone tissue. Over time, bones can become fragile and misshapen. The pelvis, skull, spine and legs are most commonly affected. […] Bisphosphonates the medications used to strengthen bones weakened by osteoporosis are the mainstay of treatment. Surgery may be necessary if complications occur. […] Most people who have Paget’s disease of bone have no symptoms. When symptoms occur, the most common complaint is bone pain. […] Because this disease causes your body to generate new bone faster than normal, the rapid remodeling produces bone that’s less organized and weaker than normal bone, which can lead to bone pain, deformities and fractures. […] Talk to your doctor if you have: Pain in your bones and joints, Tingling and weakness in an extremity, Bone deformities, Unexplained hearing loss, especially if it’s only on one side.

• #1 Paget’s disease of bone – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pagets-disease-of-bone/diagnosis-treatment/drc-20350816

  During the physical exam, your doctor will examine areas of your body that are causing you pain. […] If the disease is active indicated by an elevated alkaline phosphatase level and is affecting high-risk sites in your body, such as your skull or spine, your doctor might recommend treatment to prevent complications, even if you don’t have symptoms. […] Osteoporosis drugs (bisphosphonates) are the most common treatment for Paget’s disease of bone. […] If you can’t tolerate bisphosphonates, your doctor might prescribe calcitonin (Miacalcin), a naturally occurring hormone involved in calcium regulation and bone metabolism. […] To reduce your risk of complications associated with Paget’s disease of bone, try these tips: […] Paget’s disease of bone puts you at high risk of bone fractures.

• #1 Paget’s disease of bone: when and why to refer to specialist care

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7594827/

  Pagets disease of bone (PDB) is characterised by increased but disorganised bone remodelling, leading to various complications including pain, deformity, and fracture. […] This article provides guidance to primary care teams on the diagnosis and management of patients with PDB based on a recent clinical guideline. […] The most common presentation is with bone pain but PDB can also present with bone deformity, deafness, or pathological fractures. […] Patients with an isolated elevation in ALP should be considered for radionuclide bone scan imaging as this is the most sensitive way of detecting PDB. […] Referral to secondary care is advisable in a patient thought to have pain or deformity due to PDB so that further assessment can be performed and treatment offered if appropriate. […] Bisphosphonates are the treatment of first choice and are indicated in patients with pain localised to an affected site with evidence of increased metabolic activity.

• #1 Paget’s Disease Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/pagets-disease-nursing-diagnosis/

  Pagets disease of bone is a chronic disorder characterized by abnormal bone remodeling, resulting in enlarged and weakened bones. This nursing diagnosis is crucial for healthcare providers to understand as it can lead to serious complications if left untreated, including bone deformities, fractures, and, in rare cases, bone cancer. […] The following are the common nursing care planning goals and expected outcomes for Pagets disease: The patient will report reduced bone pain. The patient will demonstrate improved mobility and range of motion. The patient will maintain bone integrity without new fractures. The patient will show normal or stabilized serum alkaline phosphatase levels. […] Nursing interventions and care are essential for managing Pagets disease. In the following section, you’ll learn about possible nursing interventions for a patient with Pagets disease.

• #1 Paget’s Disease Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/pagets-disease-nursing-diagnosis/

  Administer medications as prescribed. Medications are a cornerstone of Pagets disease management. Common medications include: Bisphosphonates (e.g., alendronate, risedronate), Calcitonin, Pain relievers (e.g., NSAIDs, acetaminophen). […] Provide patient education. Educate the patient about Pagets disease, its progression, and management strategies. This includes information on: Disease process, Importance of medication adherence, Potential complications, Lifestyle modifications. […] Implement pain management strategies. Work with the patient to develop effective pain management techniques, which may include: Proper use of prescribed pain medications, Application of heat or cold therapy, Relaxation techniques. […] Promote safe mobility. Assist the patient in maintaining mobility while reducing the risk of falls or fractures. This may involve: Teaching proper body mechanics, Recommending assistive devices, Suggesting home modifications for safety.

• #1 Paget Disease of Bone for Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0815/p224.html

  Early diagnosis of Paget disease of bone remains key to its management because patients generally have a good prognosis if treatment is initiated before major complications arise. […] Nitrogen-containing bisphosphonates are recommended for the treatment of bone pain associated with Paget disease. […] A single 5-mg dose of zoledronic acid (Reclast) given intravenously is the treatment of choice. […] Follow-up is required to monitor treatment response in patients who received antipagetic therapy, disease progression in asymptomatic patients who did not receive treatment, and signs of disease recurrence in patients who had been in remission. […] Total serum alkaline phosphatase is the suggested marker for assessing treatment response when high bone turnover occurs, measured at three to six months to assess initial response.

• #1 Treatment and care for patients with Paget’s disease of bone | Nursing Times

  https://www.nursingtimes.net/musculoskeletal-and-orthopaedics/latest-musculoskeletal-and-orthopaedics-clinical-practice/treatment-and-care-for-patients-with-pagets-disease-of-bone-02-02-2002/

  Pagets disease of bone was first described by the English surgeon, Sir James Paget, in 1876. […] This article reviews the epidemiology, clinical features and management of the disease and examines how early recognition and treatment may help reduce the morbidity associated with it. […] Despite its frequency, many patients have not heard of the disease and they and their carers should be given information and education about it. Education helps allay patients fears about the disease and allows them to participate actively in its management. […] Analgesia is needed for pain control and should be tailored according to the patients symptoms. […] Patients with functional impairment, usually as a consequence of skeletal deformity or complications such as osteoarthrosis, require assessment and, if appropriate, intervention by the multidisciplinary team, which includes a physiotherapist and occupational therapist.

• #1 Treatment for Paget’s Disease of the Bone | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/pagets-disease-of-the-bone/treatments.html

  Many people don’t need treatment for Paget’s disease. But even if you don’t need treatment, you will still need to see your doctor on a regular basis from now on. This will let your doctor watch for other problems you might get from the disease, such as arthritis, fractures, or nerve problems. […] Your doctor may prescribe medicine if you have symptoms or if you have no symptoms but you are at risk for other problems from Paget’s disease. Medicine can help reduce the breakdown of bone tissue, control symptoms such as bone pain, and prevent other problems such as arthritis, fractures, or nerve damage. […] Bisphosphonates are usually the first medicines prescribed for Paget’s disease. They often make the disease inactive, sometimes for years or decades. If it becomes active again, you may need to take this medicine off and on to keep the disease under control.

• #1 Paget’s Disease of the Bone: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21929-pagets-disease-of-the-bone

  There’s currently no cure for Pagets disease of the bone, but its treatable. The sooner Pagets disease can be diagnosed and treated, the less likely that youll experience complications from the disease. […] If you have Pagets disease of the bone and take medication, its important to follow your healthcare providers instructions for taking your medicine. […] While medication and surgery are the only methods that can treat Pagets disease of the bone, there are things you can do to help keep your skeletal system healthy in general, including: […] Maintain a healthy weight: Having obesity can cause extra pressure on your joints. Try to maintain a healthy weight to keep your joints and bones healthy. […] Exercise: Physical activity can help keep your skeletal system healthy and can help maintain your joint mobility. Be sure to talk with your healthcare provider before you begin an exercise routine. Certain exercises could put too much pressure on your bones that are affected by Pagets disease. […] Get enough calcium and vitamin D: Calcium and vitamin D help keep bones strong and healthy. Be sure you’re consuming enough calcium and vitamin D in your diet and/or through supplements.

• #1 Paget’s disease of bone | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/pagets-disease-of-bone?content_id=CON-20155273

  If you’re scheduled for surgery that involves bones affected by Paget’s disease of bone, your doctor might prescribe medications to reduce the activity of the disease, which may help reduce blood loss during surgery. […] To reduce your risk of complications associated with Paget’s disease of bone, try these tips: Prevent falls. Paget’s disease of bone puts you at high risk of bone fractures. […] Regular exercise is essential for maintaining joint mobility and bone strength. Talk to your doctor before beginning an exercise program to determine the right type, duration and intensity of exercise for you. Some activities may place too much stress on your affected bones.

• #1 Paget’s Disease of Bone | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/pagets-disease-of-bone-hw191694

  If you still have pain while taking your prescribed medicine, you can try: […] You might also need other treatments, such as: […] There are many things you can do to help yourself when you have Paget’s disease. […] Take care to avoid falls. For example, keep your home’s walkways free of clutter and electric cords. Put grab bars in your bathroom. […] Do weight-bearing exercise to keep your bones strong. Walking, dancing, or lifting weights may be good, but make sure that you don’t put stress on affected bones. Your doctor or physical therapist can suggest exercises for you. […] Eat a healthy diet that includes plenty of calcium and vitamin D. You need both to build strong bones.

• #1 Paget’s disease – Nurses Revision

  https://nursesrevisionuganda.com/pagets-disease/

  Pharmacological Treatment. The medications used in the management of Pagets disease include: […] Administer analgesics as prescribed prior to exercise/ physical activity. Teach deep breathing exercises and relaxation techniques. Provide adequate ventilation in the room. […] If the patient is for surgery, explain the surgical procedure related to Pagets to the patient and caregiver. The doctor may recommend surgery to resolve unbearable joint pain due to Pagets disease.

• #1 Paget’s Disease: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/pagets-disease-of-bone-pro

  Drug treatment: Non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol may be effective for pain. […] Anti-resorptive therapy is usually with bisphosphonates. […] Bisphosphonates are recommended for the treatment of bone pain associated with Paget’s disease. […] Serial monitoring of alkaline phosphatase is used to monitor the effects of treatment and disease activity. […] Surgery: Bone deformity, osteoarthritis, pathological fractures and nerve compression may necessitate surgery. […] Bisphosphonates should be used pre-operatively to try to reduce disease activity in order to prevent severe bleeding during surgery. […] After surgery, bone healing may be prolonged, and lengthy rehabilitation may be necessary. […] Total hip or knee replacements are recommended for patients with Paget’s disease who develop osteoarthritis in whom medical treatment is inadequate.

• #1 Paget’s Disease of Bone – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/pagets-disease-of-bone

  Paget’s disease of bone is a chronic disease of the skeleton. In most cases, treatment for Pagets disease involves taking medications to help slow or stop the progress of the disease. For patients who have complications, surgery may be needed to realign deformed bones or to help fractures heal. […] If symptoms do occur, your doctor may recommend one or more nonsurgical treatments. […] Nonsteroidal anti-inflammatory drugs (NSAIDs). Medications such as ibuprofen, naproxen, and aspirin can help relieve mild bone pain that arises from Pagets disease or from arthritis that may be associated with the disease. […] Bisphosphonate medications. When bone pain is more significant, medications called bisphosphonates are the treatment of choice. These drugs block osteoclasts and can be very effective in treating Paget’s disease.

• #1 Paget Disease of Bone – Musculoskeletal and Connective Tissue Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/paget-disease-of-bone/paget-disease-of-bone

  Several antiresorptive agents that suppress osteoclast activity and decrease bone pain are available for treating Paget disease. […] Bisphosphonates are the medication class of choice. […] Synthetic salmon calcitonin is an alternative to bisphosphonates for patients intolerant of or resistant to them. […] Because bone turnover is increased, patients should ensure adequate intake of calcium and vitamin D, and supplements are often needed.

• #1 Paget’s Disease: Causes, Symptoms, and Treatments | Arthritis Foundation

  https://www.arthritis.org/diseases/pagets-disease

  Paget’s disease of the bone occurs when an error in the normal process of bone breakdown and rebuilding causes new bone to grow faster than normal resulting in weak and misshapen bones. […] The goal of treatment is to relieve pain and slow down the progression of the disease. […] Taking a proactive role in treatment a process called self-management is important. Here are some ways to help manage the disease: […] To maintain strong bones, you should get 1,200 mg of calcium and at least 400 IU of vitamin D every day. […] Exercise helps keep joints mobile and build strong bones.

• #1

  https://www.nhs.uk/conditions/pagets-disease-bone/treatment/

  There’s currently no cure for Paget’s disease of bone, but treatment can help relieve the symptoms. […] If you need bisphosphonates you’ll usually have a medicine called zoledronate. It’s given as a single dose through a drip in your arm (infusion). […] Zoledronate can help reduce pain for several years at a time. Treatment can be repeated when the effect starts to wear off. […] Some people with Paget’s disease benefit from supportive therapies such as physiotherapy or occupational therapy. […] These therapies involve exercises and techniques that can help reduce pain, improve movement and make everyday tasks easier. […] Surgery is usually only needed if further problems develop, such as fractures, deformities or severe osteoarthritis. […] Calcium and vitamin D help keep your bones healthy. If you have Paget’s disease of bone, it’s important to ensure you get enough of these.

• #1 Paget’s disease of bone | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pagets-disease-of-bone

  seek supportive therapies as well as tailored exercises, physiotherapists and occupational therapists can also provide techniques and devices that can help to improve movement, reduce pain and make everyday activities easier. […] enjoy a healthy well-balanced diet this can help you reach and maintain a healthy weight and reduce your risk of other health problems. […] learn new ways to manage pain there are many things you can do to manage pain, and different strategies will work for different situations. […] stay at work its good for your health and wellbeing. […] join a peer support group dealing with a chronic condition like Paget’s disease of bone can be isolating. […] In severe cases, surgery may be required to relieve pinched nerves or bone fractures, or to replace a joint severely affected by arthritis.

• #1 Paget’s Disease of the Bone: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21929-pagets-disease-of-the-bone

  Pagets disease of the bone is a rare chronic bone disorder in which there’s excessive and disordered bone turnover with both excessive resorption and formation. A person with Pagets disease of the bone is more likely to experience bone fractures (breaks). When the disease is around a joint, it can cause arthritis. […] Treatments for Pagets disease of the bone can include: […] Medication: Many medications can treat Pagets disease of the bone. The most common type is bisphosphonates. The most effective bisphosphonate is zoledronate (Reclast). Often, one dose of this drug can result in long-lasting remission of the disease but it cant correct bone deformities. […] Surgery: You might need surgery to fix or improve complications of Pagets disease of the bone. Some surgeries include knee or hip replacements, surgery to realign deformed bone and surgery to enable bone fractures to heal in a better position.

• #1 Paget’s Disease of Bone – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/pagets-disease-of-bone

  In some cases, surgery may be needed to treat the complications of Paget’s disease, including: Bone fractures, Malalignment or deformity of bone, Severe arthritis. […] The surgical procedures used to treat fractures, malalignment, or arthritis in patients with Paget’s disease are similar to those used to treat similar conditions in people with normal bone. […] If treatment occurs before major changes in bone occur, the majority of patients with Pagets disease are able to live a normal, active life. When complications do develop, surgical treatment is usually effective in relieving pain and improving function.

• #1 Paget’s Disease Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/pagets-disease-nursing-diagnosis/

  Monitor for complications. Regularly assess for signs of complications such as fractures, arthritis, or neurological changes. Early detection can lead to prompt intervention. […] Encourage regular follow-up. Stress the importance of regular medical check-ups and bone density scans to monitor disease progression and treatment effectiveness. […] Provide nutritional counseling. Advise on a diet rich in calcium and vitamin D to support bone health. This may include: Recommending calcium-rich foods, Discussing vitamin D supplementation if necessary. […] Support psychosocial needs. Offer emotional support and refer to support groups or counseling services if needed. Chronic conditions can have significant psychological impacts. […] Collaborate with the healthcare team. Work closely with physicians, physical therapists, and other healthcare providers to ensure comprehensive care. […] Prepare for potential surgical interventions. In some cases, surgery may be necessary to manage complications of Pagets disease. Prepare the patient for potential procedures such as: Joint replacement, Fracture repair, Osteotomy (bone cutting) to correct deformities.

• #1 Paget Bone Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430805/

  Paget disease is a skeletal growth disorder in which abnormalities such as unusual bone growth can occur in several multifactorial ways. […] It can be treated very effectively with the use of bisphosphonates. […] Implement evidence-based treatment strategies for Paget disease of the bone, including pharmacological interventions, to manage symptoms and reduce disease progression. […] Patients diagnosed with Paget disease of the bone need to be educated on the symptoms and complications of the disease to help with timely diagnosis and progression. […] The nurse should reinforce education about safe ambulation to prevent fractures. […] Symptomatic patients usually can be managed by bisphosphonates, calcitonin, and vitamin D supplements. […] Managing Paget’s disease of the bone requires a collaborative, patient-centered approach involving physicians, advanced care practitioners, nurses, pharmacists, and other healthcare professionals. […] Patients need to be referred to a physical therapist as they will benefit from learning about body mechanics, proper posture, and avoidance of trauma. […] Managing Paget’s disease of the bone demands a multidisciplinary team effort.

• #1 Paget’s disease 2: Exploring diagnosis, management and support strategies | Nursing Times

  https://www.nursingtimes.net/assessment-skills/pagets-disease-2-exploring-diagnosis-management-and-support-strategies-07-05-2009/

  Patients with Pagets disease may be managed in primary care or as outpatients. However, inpatient care may be necessary if surgery is needed, there are doubts about the diagnosis or a patient has marked pain. […] Primary care nurses and those in relevant specialties should have basic knowledge of diagnosing the condition, commonly prescribed drug therapy and surgical options. […] Treatment is recommended when patients have bone pain localised to an affected site. In the absence of pain, Selby et al (2002) suggested that treatment should be considered to prevent further complications but there is a lack of consensus on this. […] Nurses have a key role in explaining drug effects and encouraging adherence. Common side-effects of oral treatment include indigestion and nausea and patients may have problems complying with dosing instructions.

• #1 Paget’s disease: A therapy update

  https://www.myamericannurse.com/pagets-disease-a-therapy-update/

  Youve probably heard of Pagets disease, but you may not realize its the second most common metabolic bone disease, after osteoporosis. […] Appropriate therapy may suppress disease activity and prevent further complications. Thats why its important for you to understand this disease, be able to recognize symptoms, and teach patients about management. […] Nurses can help patients and their families understand Pagets disease and its treatment. Increasing concerns about skeletal health, complications, and safety of drug therapy can cause stress and anxiety. Education and counseling help allay these concerns. […] Inform patients that bisphosphonates dont cure the disease, but they can control it. Tell them complete biochemical remission is less likely in patients with the greatest disease severity. Encourage patients to follow their individualized treatment plan to help minimize symptoms, improve physical functioning, slow disease progress, and limit disability.

• #2 Paget’s disease of bone: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/177668

  Pagets disease is the second most common type of bone disease after osteoporosis. […] Treatment can control Pagets disease and reduce the impact of symptoms, but no full cure is available. […] Not all people with Pagets disease will need treatment, but if there are symptoms, or if tests show that treatment is necessary, the first line of treatment will normally be bisphosphonates. […] Bisphosphonates are medications that help reduce the breakdown of disordered bone. […] People receiving bisphosphonates also need to maintain adequate levels of vitamin D and calcium. […] Surgery may be necessary if Pagets disease leads to a significant bone deformity or a break in the bone. […] The outlook with Pagets disease is generally good, especially if people receive treatment before major bone changes occur.

• #2 Paget’s Disease of Bone | MedlinePlus

  https://medlineplus.gov/pagetsdiseaseofbone.html

  Paget’s disease of bone is a chronic bone disorder. Normally, there is a process in which your bones break down and then regrow. In Paget’s disease, this process is abnormal. There is excessive breakdown and regrowth of bone. Because the bones regrow too quickly, they are bigger and softer than normal. They may be misshapen and easily fractured (broken). Paget’s usually affects just one or a few bones. […] To avoid complications, it is important to find and treat Paget’s disease early. The treatments include: […] Medicines. There are several different medicines to treat Paget’s disease. The most common type is bisphosphonates. They help reduce bone pain and stop or slow down the progress of the disease. […] Diet and exercise do not treat Paget’s, but they can help to keep your skeleton healthy. If you do not have kidney stones, you should make sure to get enough calcium and vitamin D through your diet and supplements. Besides keeping your skeleton healthy, exercise can prevent weight gain and maintain the mobility of your joints. Talk with your health care provider before you start a new exercise program. You need to make sure that the exercise does not put too much stress on the affected bones.

• #2 Paget’s disease of bone – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pagets-disease-of-bone/symptoms-causes/syc-20350811

  Paget’s (PAJ-its) disease of bone interferes with your body’s normal recycling process, in which new bone tissue gradually replaces old bone tissue. Over time, bones can become fragile and misshapen. The pelvis, skull, spine and legs are most commonly affected. […] Bisphosphonates the medications used to strengthen bones weakened by osteoporosis are the mainstay of treatment. Surgery may be necessary if complications occur. […] Most people who have Paget’s disease of bone have no symptoms. When symptoms occur, the most common complaint is bone pain. […] Because this disease causes your body to generate new bone faster than normal, the rapid remodeling produces bone that’s less organized and weaker than normal bone, which can lead to bone pain, deformities and fractures. […] Talk to your doctor if you have: Pain in your bones and joints, Tingling and weakness in an extremity, Bone deformities, Unexplained hearing loss, especially if it’s only on one side.

• #2 Paget’s Disease of Bone | CommonSpirit Health

  https://www.commonspirit.org/conditions-treatments/pagets-disease-of-bone

  Paget’s disease is a problem of abnormal bone growth. It may affect just one bone, but it usually affects more than one. […] Paget’s disease is most common in people older than 50, and the risk of getting it increases with age. Most people who have it are able to lead normal lives. […] Most people with Paget’s disease have no symptoms. When symptoms occur, the most common ones are: Bone pain. It may be worse at night and get better with exercise. People often mistake the pain for normal aging or arthritis. […] You may not need treatment. But you will need regular doctor visits to watch for problems from the disease, such as arthritis. If you need treatment, your doctor may prescribe medicine to reduce bone loss and control symptoms. You might also need other treatments, such as over-the-counter pain relievers, physical therapy, or splints.

• #2 Osteoporosis & Paget Disease of Bone – Free Sketchy Medical Lesson

  https://www.sketchy.com/medical-lessons/osteoporosis-paget-disease-of-bone

  Pagets disease, also known as osteitis deformans, is characterized by an increase in bone resorption that leads to a decrease in bone mass and lytic structures. Pagets disease progresses in multiple phases, beginning with the osteolytic phase, which features extensive osteoclastic activity leading to bone resorption. This is followed by a mixed phase where both osteoblasts and osteoclasts are active, causing rapid but disorganized bone turnover. The subsequent osteosclerotic phase involves the formation of bulky, fragile bone. The final phase is the quiescent phase, knows as the burned-out phase, where malignant degeneration is seen. […] Clinical manifestations of Paget’s disease include skull enlargement, often causing patients to report that their hats no longer fit. Hearing loss can occur due to cochlear involvement. Physical deformities such as bowing asymmetry of the lower extremities, as well as osteoarthritis are also observed. The affected bone in Pagets disease is weak and susceptible to chalk-stick fractures that cause bone pain.

• #2 Paget Disease of Bone for Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0815/p224.html

  Paget disease of bone is a benign disorder characterized by focal areas of increased bone turnover in one or more skeletal sites. […] Pain is the most common symptom, and presentation of the disease may depend on which bones are affected, the extent of involvement, and the presence of complications. […] Evidence-based guidelines recommend the use of plain radiography and serum alkaline phosphatase testing for initial diagnosis and radionuclide scans for delineation of the extent of disease. […] Treatment with nitrogen-containing bisphosphonates is recommended in active disease or when risk of complications is possible. […] Total serum alkaline phosphatase is the suggested marker for assessing treatment response when high bone turnover occurs, and it should be measured at three to six months to evaluate initial response.

• #2 Paget’s disease of bone: when and why to refer to specialist care | British Journal of General Practice

  https://bjgp.org/content/70/700/561

  Pagets disease of bone (PDB) is characterised by increased but disorganised bone remodelling, leading to various complications including pain, deformity, and fracture. […] This article provides guidance to primary care teams on the diagnosis and management of patients with PDB based on a recent clinical guideline. […] A suggested pathway for diagnosis and referral is shown in Figure 1. Patients with an isolated elevation in ALP should be considered for radionuclide bone scan imaging as this is the most sensitive way of detecting PDB. […] The main purpose of performing imaging is to identify which bones are affected to help decide if a patients symptoms might be due to PDB or another cause. […] Referral to secondary care is advisable in a patient thought to have pain or deformity due to PDB so that further assessment can be performed and treatment offered if appropriate. […] Bisphosphonates are the treatment of first choice and are indicated in patients with pain localised to an affected site with evidence of increased metabolic activity.

• #2 Paget’s disease – Nurses Revision

  https://nursesrevisionuganda.com/pagets-disease/

  Pagets disease of bone also known as osteitis deformans is a chronic disease of the skeleton characterized by focal excessive bone remodeling. and is the second most common bone disease worldwide after osteoporosis. […] Pagets disease of bone is a disorder in which theres a lot of bone remodeling that happens in some regions of the bone. Typically theres excessive bone resorption followed by excessive bone growth, and that leads to skeletal deformities and potential fractures. […] There is no cure for Pagets disease and no way to reverse its effects on bone. […] Aims; To relieve bone pain and prevent the progression of the disease […] Treatment focuses on the relief of symptoms […] Prevention of future complications. […] Non-pharmacological Therapy. Physical therapy for the improvement of muscle strength and pain relief in some types of pain.

• #2 Paget Bone Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430805/

  Paget disease is a skeletal growth disorder in which abnormalities such as unusual bone growth can occur in several multifactorial ways. […] It can be treated very effectively with the use of bisphosphonates. […] Implement evidence-based treatment strategies for Paget disease of the bone, including pharmacological interventions, to manage symptoms and reduce disease progression. […] Patients diagnosed with Paget disease of the bone need to be educated on the symptoms and complications of the disease to help with timely diagnosis and progression. […] The nurse should reinforce education about safe ambulation to prevent fractures. […] Symptomatic patients usually can be managed by bisphosphonates, calcitonin, and vitamin D supplements. […] Managing Paget’s disease of the bone requires a collaborative, patient-centered approach involving physicians, advanced care practitioners, nurses, pharmacists, and other healthcare professionals. […] Patients need to be referred to a physical therapist as they will benefit from learning about body mechanics, proper posture, and avoidance of trauma. […] Managing Paget’s disease of the bone demands a multidisciplinary team effort.

• #2 Paget’s disease – Nurses Revision

  https://nursesrevisionuganda.com/pagets-disease/

  Pharmacological Treatment. The medications used in the management of Pagets disease include: […] Administer analgesics as prescribed prior to exercise/ physical activity. Teach deep breathing exercises and relaxation techniques. Provide adequate ventilation in the room. […] If the patient is for surgery, explain the surgical procedure related to Pagets to the patient and caregiver. The doctor may recommend surgery to resolve unbearable joint pain due to Pagets disease.

• #2 Treatment and care for patients with Paget’s disease of bone | Nursing Times

  https://www.nursingtimes.net/musculoskeletal-and-orthopaedics/latest-musculoskeletal-and-orthopaedics-clinical-practice/treatment-and-care-for-patients-with-pagets-disease-of-bone-02-02-2002/

  Patients with lower limb deformities may develop secondary foot problems and should be referred for podiatric assessment. […] Patients with lower limb disease should be advised on the degree of activity and rest that they can undertake, including the importance of pacing and planning activities. […] In all these aspects of care the nurse has an important role to play. […] Until relatively recently there was no effective treatment for Pagets disease. […] Treatment with bisphosphonates is recommended for patients with bone pain or other symptoms of active disease and also for potentially reversible complications, including neurological compression syndromes. […] In routine clinical practice, treatment with bisphosphonates is usually monitored by assessment of the patients symptoms and by measuring the serum alkaline phosphatase level.

• #2 Paget’s Disease: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/pagets-disease-of-bone-pro

  Drug treatment: Non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol may be effective for pain. […] Anti-resorptive therapy is usually with bisphosphonates. […] Bisphosphonates are recommended for the treatment of bone pain associated with Paget’s disease. […] Serial monitoring of alkaline phosphatase is used to monitor the effects of treatment and disease activity. […] Surgery: Bone deformity, osteoarthritis, pathological fractures and nerve compression may necessitate surgery. […] Bisphosphonates should be used pre-operatively to try to reduce disease activity in order to prevent severe bleeding during surgery. […] After surgery, bone healing may be prolonged, and lengthy rehabilitation may be necessary. […] Total hip or knee replacements are recommended for patients with Paget’s disease who develop osteoarthritis in whom medical treatment is inadequate.

• #2 Paget’s disease: A therapy update

  https://www.myamericannurse.com/pagets-disease-a-therapy-update/

  Youve probably heard of Pagets disease, but you may not realize its the second most common metabolic bone disease, after osteoporosis. […] Appropriate therapy may suppress disease activity and prevent further complications. Thats why its important for you to understand this disease, be able to recognize symptoms, and teach patients about management. […] Nurses can help patients and their families understand Pagets disease and its treatment. Increasing concerns about skeletal health, complications, and safety of drug therapy can cause stress and anxiety. Education and counseling help allay these concerns. […] Inform patients that bisphosphonates dont cure the disease, but they can control it. Tell them complete biochemical remission is less likely in patients with the greatest disease severity. Encourage patients to follow their individualized treatment plan to help minimize symptoms, improve physical functioning, slow disease progress, and limit disability.

• #2 Paget’s Disease: Causes, Symptoms, and Treatments | Arthritis Foundation

  https://www.arthritis.org/diseases/pagets-disease

  Paget’s disease of the bone occurs when an error in the normal process of bone breakdown and rebuilding causes new bone to grow faster than normal resulting in weak and misshapen bones. […] The goal of treatment is to relieve pain and slow down the progression of the disease. […] Taking a proactive role in treatment a process called self-management is important. Here are some ways to help manage the disease: […] To maintain strong bones, you should get 1,200 mg of calcium and at least 400 IU of vitamin D every day. […] Exercise helps keep joints mobile and build strong bones.

• #2 Paget’s Disease of Bone | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.paget’s-disease-of-bone.hw191694

  If you still have pain while taking your prescribed medicine, you can try: An over-the-counter pain reliever such as acetaminophen, naproxen, or ibuprofen. Be safe with medicines. Read and follow all instructions on the label. […] You might also need other treatments, such as: Physical therapy to build your muscles and improve your balance. This can help reduce falls and prevent broken bones. […] There are many things you can do to help yourself when you have Paget’s disease. […] Take care to avoid falls. For example, keep your home’s walkways free of clutter and electric cords. Put grab bars in your bathroom. […] Do weight-bearing exercise to keep your bones strong. Walking, dancing, or lifting weights may be good, but make sure that you don’t put stress on affected bones. Your doctor or physical therapist can suggest exercises for you. […] Eat a healthy diet that includes plenty of calcium and vitamin D. You need both to build strong bones.

• #2 Osteoporosis, Osteomalacia, Paget’s Disease – LevelUpRN

  https://leveluprn.com/blogs/medical-surgical-nursing/musculoskeletal-5-osteoporosis-osteomalacia-pagets-disease?srsltid=AfmBOoo747-5gDWeHzoQteHWXjkbPdsLCV7JQuB9yDmz8NN_deFmJeyA

  Finally, let’s talk about Paget’s disease, which is a metabolic disorder that causes bones to become soft, structurally disorganized, and weak. And this places the patient at high risk for fractures. […] In terms of treatment, analgesics can be used for bone pain. We can also provide the patient with osteoporosis medications such as Calcitonin and alendronate. […] And in terms of patient teaching, we want to encourage the patient to engage in gentle exercises to help maintain their mobility. We also want them to implement safety precautions because we want to prevent falls. If the patient were to fall, they are at high risk for fractures with this disorder.

• #2 Paget’s disease of bone – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pagets-disease-of-bone/diagnosis-treatment/drc-20350816

  Regular exercise is essential for maintaining joint mobility and bone strength. […] If you’re scheduled for surgery that involves bones affected by Paget’s disease of bone, your doctor might prescribe medications to reduce the activity of the disease, which may help reduce blood loss during surgery.

• #2 Paget’s disease of bone | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/pagets-disease-of-bone?content_id=CON-20155273

  If you’re scheduled for surgery that involves bones affected by Paget’s disease of bone, your doctor might prescribe medications to reduce the activity of the disease, which may help reduce blood loss during surgery. […] To reduce your risk of complications associated with Paget’s disease of bone, try these tips: Prevent falls. Paget’s disease of bone puts you at high risk of bone fractures. […] Regular exercise is essential for maintaining joint mobility and bone strength. Talk to your doctor before beginning an exercise program to determine the right type, duration and intensity of exercise for you. Some activities may place too much stress on your affected bones.

• #2 Paget’s disease of bone – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pagets-disease-of-bone/diagnosis-treatment/drc-20350816

  During the physical exam, your doctor will examine areas of your body that are causing you pain. […] If the disease is active indicated by an elevated alkaline phosphatase level and is affecting high-risk sites in your body, such as your skull or spine, your doctor might recommend treatment to prevent complications, even if you don’t have symptoms. […] Osteoporosis drugs (bisphosphonates) are the most common treatment for Paget’s disease of bone. […] If you can’t tolerate bisphosphonates, your doctor might prescribe calcitonin (Miacalcin), a naturally occurring hormone involved in calcium regulation and bone metabolism. […] To reduce your risk of complications associated with Paget’s disease of bone, try these tips: […] Paget’s disease of bone puts you at high risk of bone fractures.

• #2

  https://www.nhs.uk/conditions/pagets-disease-bone/treatment/

  There’s currently no cure for Paget’s disease of bone, but treatment can help relieve the symptoms. […] If you need bisphosphonates you’ll usually have a medicine called zoledronate. It’s given as a single dose through a drip in your arm (infusion). […] Zoledronate can help reduce pain for several years at a time. Treatment can be repeated when the effect starts to wear off. […] Some people with Paget’s disease benefit from supportive therapies such as physiotherapy or occupational therapy. […] These therapies involve exercises and techniques that can help reduce pain, improve movement and make everyday tasks easier. […] Surgery is usually only needed if further problems develop, such as fractures, deformities or severe osteoarthritis. […] Calcium and vitamin D help keep your bones healthy. If you have Paget’s disease of bone, it’s important to ensure you get enough of these.

• #2 Paget Disease of Bone – Musculoskeletal and Connective Tissue Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/paget-disease-of-bone/paget-disease-of-bone

  Several antiresorptive agents that suppress osteoclast activity and decrease bone pain are available for treating Paget disease. […] Bisphosphonates are the medication class of choice. […] Synthetic salmon calcitonin is an alternative to bisphosphonates for patients intolerant of or resistant to them. […] Because bone turnover is increased, patients should ensure adequate intake of calcium and vitamin D, and supplements are often needed.

• #2

  https://www.orthobullets.com/pathology/8040/pagets-disease

  Paget’s Disease is an idiopathic condition of abnormal bone remodeling with normal bone being replaced through an active interplay between excessive bone resorption and abnormal new bone formation. The condition typically present in patients age 40 with asymptomatic lesions discovered incidentally on radiographs. […] Treatment is observation for asymptomatic patients. Medical management with bisphosphonates is indicated in symptomatic patients. […] Nonoperative observation and supportive therapy treatment for asymptomatic Paget’s disease includes physiotherapy, NSAIDS, oral analgesics. […] Medical therapy aimed at osteoclast inhibition bisphosphonates are 1st line treatment for symptomatic Pagets. […] Calcitonin are 2nd line (after bisphosphonates) causes osteoclasts to shrink in size and decreases their bone resorptive activity within minutes. […] Operative THA / TKA indications affected patients with degenerative joint disease. […] Technique treat Paget’s with pharmacologic agents prior to arthroplasty to reduce bleeding. […] Outcomes greater incidence of suboptimal alignment secondary to pagetoid bone.

• #2 Paget’s Disease of Bone

  https://rheumatology.org/patients/pagets-disease-of-bone

  Pagets disease of bone is an uncommon, chronic condition where bone rebuilds at a faster than normal rate. […] Pagets disease usually affects people after the age of 50. […] Treatment goals focus on pain control with many common over the counter medications (acetaminophen (Tylenol), ibuprofen (Advil, Motrin) and decrease bone turnover to prevent complications such as fracture. […] Surgery may be needed to treat arthritis caused by bone changes to ease pain and improve function. […] Most people with Pagets disease can have a good quality of life. […] Prompt diagnosis and treatment can help them manage their disease effectively. […] People with Pagets disease may benefit from physical therapy, cane, walker, bracing and cushioning devices to help improve symptoms or to prevent falls that could lead to a fracture.

• #2 Paget’s Disease of the Bone: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21929-pagets-disease-of-the-bone

  There’s currently no cure for Pagets disease of the bone, but its treatable. The sooner Pagets disease can be diagnosed and treated, the less likely that youll experience complications from the disease. […] If you have Pagets disease of the bone and take medication, its important to follow your healthcare providers instructions for taking your medicine. […] While medication and surgery are the only methods that can treat Pagets disease of the bone, there are things you can do to help keep your skeletal system healthy in general, including: […] Maintain a healthy weight: Having obesity can cause extra pressure on your joints. Try to maintain a healthy weight to keep your joints and bones healthy. […] Exercise: Physical activity can help keep your skeletal system healthy and can help maintain your joint mobility. Be sure to talk with your healthcare provider before you begin an exercise routine. Certain exercises could put too much pressure on your bones that are affected by Pagets disease. […] Get enough calcium and vitamin D: Calcium and vitamin D help keep bones strong and healthy. Be sure you’re consuming enough calcium and vitamin D in your diet and/or through supplements.

• #2 Treatment for Paget’s Disease of the Bone | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/pagets-disease-of-the-bone/treatments.html

  You might also need other treatments, such as: […] Physical therapy to build your muscles and improve your balance. This can help reduce falls and prevent broken bones. […] Splints or braces to support your bones and joints and to help keep weak bones from breaking. […] A cane or walker to help you avoid falling and breaking a bone. […] A hearing aid if the disease has caused hearing loss. […] Some people may need surgery to replace a damaged hip or knee joint.

• #2 Paget’s Disease of Bone – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/pagets-disease-of-bone

  In some cases, surgery may be needed to treat the complications of Paget’s disease, including: Bone fractures, Malalignment or deformity of bone, Severe arthritis. […] The surgical procedures used to treat fractures, malalignment, or arthritis in patients with Paget’s disease are similar to those used to treat similar conditions in people with normal bone. […] If treatment occurs before major changes in bone occur, the majority of patients with Pagets disease are able to live a normal, active life. When complications do develop, surgical treatment is usually effective in relieving pain and improving function.

• #2 Paget’s disease of bone: when and why to refer to specialist care | British Journal of General Practice

  https://bjgp.org/content/70/700/561

  In the UK, three bisphosphonates have marketing authorisation for the treatment of PDB. […] Although bisphosphonates can improve bone pain significantly in PDB, many patients require additional analgesics to control the elements of pain that may not be due to increased metabolic activity. […] Surgery can be technically difficult in PDB due to deformity and the presence of sclerotic bone, but outcomes are generally excellent and having PDB is not a contraindication to referring a patient for joint replacement. […] Research is now in progress to determine if intervention with bisphosphonates in asymptomatic patients with early disease can halt progression and prevent complications.

• #2 Patient education: Paget disease of bone (osteitis deformans) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/paget-disease-of-bone-osteitis-deformans-beyond-the-basics/print

  Pain medications (eg, acetaminophen, ibuprofen, or naproxen) are recommended as needed for treatment of pain that does not improve with the treatment of Paget disease. […] Most people who plan to have surgery are treated for Paget disease of bone for at least two to three months before surgery. This can help to decrease blood flow to the bone, which will help decrease bleeding during surgery. […] Most people with Paget disease live long, healthy lives troubled mostly by the musculoskeletal problems imposed by the disease or by other problems of aging.

• #2 Paget’s Disease of Bone – AARDS

  https://www.rheum-care.com/pagets-disease-of-bone/

  Pagets disease of bone is a chronic disorder that typically results in enlarged and deformed bones in one or more regions of the skeleton. […] Exercise is very important in maintaining skeletal health and is recommended for some patients with Pagets disease. Before beginning any exercise program, it is wise to discuss the program with your physician, since undue stress on affected bones should be avoided. […] Medical therapy prior to surgery is recommended to decrease bleeding during surgery and to prevent other complications during and after surgery. […] If physicians and other health care professionals are aware of the likelihood of psychological issues, they may tailor treatment plans to include psychological outcomes, which may ultimately improve quality of life for patients with Pagets disease of bone.

• #2 Paget’s disease of bone | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pagets-disease-of-bone

  seek supportive therapies as well as tailored exercises, physiotherapists and occupational therapists can also provide techniques and devices that can help to improve movement, reduce pain and make everyday activities easier. […] enjoy a healthy well-balanced diet this can help you reach and maintain a healthy weight and reduce your risk of other health problems. […] learn new ways to manage pain there are many things you can do to manage pain, and different strategies will work for different situations. […] stay at work its good for your health and wellbeing. […] join a peer support group dealing with a chronic condition like Paget’s disease of bone can be isolating. […] In severe cases, surgery may be required to relieve pinched nerves or bone fractures, or to replace a joint severely affected by arthritis.

• #2 Paget Disease of Bone for Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0815/p224.html

  Early diagnosis of Paget disease of bone remains key to its management because patients generally have a good prognosis if treatment is initiated before major complications arise. […] Nitrogen-containing bisphosphonates are recommended for the treatment of bone pain associated with Paget disease. […] A single 5-mg dose of zoledronic acid (Reclast) given intravenously is the treatment of choice. […] Follow-up is required to monitor treatment response in patients who received antipagetic therapy, disease progression in asymptomatic patients who did not receive treatment, and signs of disease recurrence in patients who had been in remission. […] Total serum alkaline phosphatase is the suggested marker for assessing treatment response when high bone turnover occurs, measured at three to six months to assess initial response.

• #2 Paget Disease of Bone for Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0815/p224.html

  Patients with osteolytic lesions should have repeat radiography one year after treatment to determine whether improvement or deterioration has occurred. […] Some patients may have other coexistent neuromuscular pathology associated with Paget disease of bone, and use of bisphosphonates alone may not be adequate.

• #2 Paget Bone Disease | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/26520

  Patients diagnosed with Paget disease of the bone need to be educated on the symptoms and complications of the disease to help with timely diagnosis and progression. […] The nurse should reinforce education about safe ambulation to prevent fractures. […] Managing Paget’s disease of the bone requires a collaborative, patient-centered approach involving physicians, advanced care practitioners, nurses, pharmacists, and other healthcare professionals. […] Patients need to be referred to a physical therapist as they will benefit from learning about body mechanics, proper posture, and avoidance of trauma. […] The pharmacist should educate the patient on medication compliance and potential adverse effects, and nursing should watch for signs of adverse drug effects and monitor treatment progress on subsequent visits, reporting any findings to the interprofessional team.

• #2 Paget’s disease 2: Exploring diagnosis, management and support strategies | Nursing Times

  https://www.nursingtimes.net/assessment-skills/pagets-disease-2-exploring-diagnosis-management-and-support-strategies-07-05-2009/

  As part of a wider healthcare team, nurses may assume the key role of counsellor to patients who are uncertain or concerned about aspects of care. To fulfil this role, it is essential to focus on the individuals needs, offer accurate information and advice and liaise with other health and social care professionals if necessary.

• #2 Treatment and care for patients with Paget’s disease of bone | Nursing Times

  https://www.nursingtimes.net/musculoskeletal-and-orthopaedics/latest-musculoskeletal-and-orthopaedics-clinical-practice/treatment-and-care-for-patients-with-pagets-disease-of-bone-02-02-2002/

  In the Hope unit, patients are treated on a day-case basis by a specialist nurse at the Medical Investigation Unit. […] The most frequent adverse reaction, affecting 20-30% of patients, is a transient flu-like syndrome comprising headache, a feeling of being hot and flushed, shivering and rigors. […] Pagets disease affects up to 5% of men and women over 55 years and may be associated with substantial disability. With the newer potent bisphosphonates that are available, the outlook for patients with Pagets disease of bone has been transformed. Early recognition and treatment of patients may help reduce the morbidity associated with the disease.

• #2 Paget’s disease 2: Exploring diagnosis, management and support strategies | Nursing Times

  https://www.nursingtimes.net/assessment-skills/pagets-disease-2-exploring-diagnosis-management-and-support-strategies-07-05-2009/

  Patients with Pagets disease may be managed in primary care or as outpatients. However, inpatient care may be necessary if surgery is needed, there are doubts about the diagnosis or a patient has marked pain. […] Primary care nurses and those in relevant specialties should have basic knowledge of diagnosing the condition, commonly prescribed drug therapy and surgical options. […] Treatment is recommended when patients have bone pain localised to an affected site. In the absence of pain, Selby et al (2002) suggested that treatment should be considered to prevent further complications but there is a lack of consensus on this. […] Nurses have a key role in explaining drug effects and encouraging adherence. Common side-effects of oral treatment include indigestion and nausea and patients may have problems complying with dosing instructions.

• #3 Paget’s disease: A therapy update

  https://www.myamericannurse.com/pagets-disease-a-therapy-update/

  Youve probably heard of Pagets disease, but you may not realize its the second most common metabolic bone disease, after osteoporosis. […] Appropriate therapy may suppress disease activity and prevent further complications. Thats why its important for you to understand this disease, be able to recognize symptoms, and teach patients about management. […] Nurses can help patients and their families understand Pagets disease and its treatment. Increasing concerns about skeletal health, complications, and safety of drug therapy can cause stress and anxiety. Education and counseling help allay these concerns. […] Inform patients that bisphosphonates dont cure the disease, but they can control it. Tell them complete biochemical remission is less likely in patients with the greatest disease severity. Encourage patients to follow their individualized treatment plan to help minimize symptoms, improve physical functioning, slow disease progress, and limit disability.

• #3 Paget’s disease of bone | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pagets-disease-of-bone

  Paget’s disease of bone is a chronic condition that causes abnormal enlargement and weakening of bones. […] Although there is no cure for Paget’s disease of bone, there are treatments available to help you live well and manage your symptoms. […] Medications used to treat Paget’s disease of bone include: Bisphosphonates used to slow the progression of Paget’s disease of bone. They help the body control the bone-building process to stimulate more normal bone growth. […] The following strategies can help you to manage your condition: learn more about Paget’s disease of bone knowing as much as possible about your condition means that you can make informed decisions about your healthcare and play an active role in the management of your condition. […] stay active exercise helps to maintain bone health and joint mobility, as well as strengthen muscles.

• #3 Paget’s Disease of Bone | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/pagets-disease-of-bone

  We recommend that plain radiographs be obtained of the pertinent regions of the skeleton in patients with suspected Paget’s disease. […] If the diagnosis is confirmed, we suggest that a radionucleotide bone scan be done to determine the extent of the disease. […] After diagnosis of Paget’s disease, we recommend measurement of serum total alkaline phosphatase or, when warranted, a more specific marker of bone formation or bone resorption to assess the response to treatment or evolution of the disease in untreated patients. […] We suggest treatment with a bisphosphonate for most patients with active Paget’s disease who are at risk for future complications. […] We suggest a single 5-mg dose of iv zoledronate as the treatment of choice in patients who have no contraindication. […] We suggest that bisphosphonate treatment may be effective in preventing or slowing the progress of hearing loss and osteoarthritis in joints adjacent to Paget’s disease and may reverse paraplegia associated with spinal Paget’s disease. […] We suggest treatment with a bisphosphonate before surgery on pagetic bone.

• #3 Paget’s Disease of Bone Causes, Symptoms, Treatment, Medications, Prevention

  https://www.medicinenet.com/pagets_disease/article.htm

  Paget’s disease is a chronic condition of bone characterized by disorder of the normal bone remodeling process. […] The medical treatment of Paget’s disease is directed toward controlling the disease activity and managing its complications. […] When Paget’s disease causes no symptoms and blood testing shows that the level of serum alkaline phosphatase is normal or minimally elevated, no treatment may be necessary. […] Bone pain can require anti-inflammatory drugs (NSAIDs) or pain-relieving medicines. […] Surgery may be necessary for damaged joints, fractures, severely deformed bones, or when nerves are being pinched by enlarged bone. […] The medical treatment of the bone of Paget’s disease involves either medicines called bisphosphonates or injectable calcitonin. […] Bisphosphonates are the mainstay of treatment for Paget’s disease of bone.

• #3 Paget’s Disease Symptoms, Causes & Treatment

  https://www.emedicinehealth.com/paget_disease/article_em.htm

  Due to the small risk of malignant transformation (formation of bone tumors) associated with Paget’s disease, those affected should see their physicians periodically throughout their lives. […] For most people, medical treatment of Paget’s disease can effectively control symptoms, and patients can remain pain free.

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