Paget's disease of bone

Last reviewed 10/2021

Paget's disease is the second most common metabolic bone disease after osteoporosis and is the commonest cause of bone dysplasia.

  • it is characterised by one or more areas of aggressive osteoclast-mediated bone resorption followed by imperfect osteoblast-mediated bone repair (1)

Involvement of the disease is monostotic in 15% of cases and polyostotic in the remainder.

  • can affect any bone but frequently the axial skeleton is involved. The usual sites include
    • pelvis (70%)
    • femur (55%)
    • lumbar spine (53%)
    • skull (42%)
    • tibia (32%) (2)
  • when long bones are affected they may become bowed
  • thickening of the skull may lead to compression of cranial nerves with consequent palsies.

Many cases of Paget's disease are asymptomatic.