mynotes4usmle:Paget Disease or Osteitis Deformans Disorder in bone remodeling, 3 stages Osteolytic
mynotes4usmle: Paget Disease or Osteitis Deformans Disorder in bone remodeling, 3 stages Osteolytic (osteoclasts) Mixed (osteclasts & osteoblasts) Osteosclerotic (osteoblasts, “burn-out”) Mosaic pattern on lamellar bone, big skull (no hat fits), foraminal narrowing (cranial nerve impingement), bone fractures, bone pain, warmth (increase vascularization). Complications: AVshunt within bone marrow, can cause high output, cardiac failure, osteosarcoma Possible underlying mechanism: Paramyxovirus infection of osteoclasts Lab: Normal Calcium and Phosphate, INCREASED ALKALINE PHOSPHATASE MCC of an isolated, asymptomatic elevation of ALKALINE PHOSPHATASE in an elderly patient.Laboratory markers for bone turnover are elevated: PINP (procollagen type I N-propeptide or just remeber that song from 50cent “pimp”), urine hydroxyprolineImaging: XR (osteolytic or mixed lytic/sclerotic lesions), radionuclide bone scan (focal increase in uptake, also for staging)Tx: bibphosphonates -- source link
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