Osteitis deformans (Paget's disease, deforming ostoz, deforming osteodystrophy) - an inflammatory disease in which there is loss of one or more bones. It is accompanied by a partial resorption (destruction) of bone tissue, followed by its excessive formation of disorganized. The result is increased in volume, easily deformable, prone to bone fractures with a large number of intraosseous vessels. For deforming osteitis is characterized by pain and deformity in the affected area. With the defeat of the skull and spine are possible neurological complications. Malignant degeneration of damaged bone is very rare. Causes of deforming osteitis unknown. Treatment is aimed at minimizing the symptoms of the disease and preventing complications.
fractures. Causes of deforming osteitis has not yet been clarified. Completely eliminate the symptoms of the disease is impossible. Symptomatic therapy and prevention of complications.
Osteitis deformans can affect any bone. On average, one patient affected bone 3 although both may damage one or the plurality of bones. The disease is quite common and occurs predominantly in men-Europeans over the age of 50 years. In people of African and Asian descent, as well as in young people of all races, it is very rare.
traumatology and orthopedics research at 15-50% of patients have first-degree relatives who also suffer from Paget's disease. Therefore, children, brothers and sisters of patients is recommended to be tested regularly to determine the level of alkaline phosphatase.
The theory of a slow virus infection suggests that the infection can occur many years before the manifestation of the disease. Subsequently, the person is a carrier of the virus, while some triggers do not cause symptoms.
osteoarthritis. Range of motion in the joints and stiffness in movement, in this case, too, worse after rest.
Affected bones thicken, become brittle. The fracture can occur even with a small injury. With the localization of osteitis in the bones of the lower extremities may bend the legs (often suffer from shin). If the spine is affected, the back can be deformed, become stooped.
The defeat of the bones of the skull may be accompanied by an increase in size of the head and its deformation. If the skull and spine deformed bones are putting pressure on the nerve trunks or nerve tissue, neurological symptoms appear. With the defeat of the seventh cranial nerve developing sensorineural hearing loss. When compression of spinal roots have a feeling tingling, tingling and numbness in the trunk and extremities. With the defeat of the bones in the wrist area can develop carpal tunnel syndrome.
The disease is accompanied by certain metabolic disorders. The amount of blood serum alkaline phosphatase increased. A diseased bone increased demand for oxygen and nutrients causes increased load on the heart.
In severe cases, it may result in the cardiovascular system, heart valve calcification, atherosclerosis, uric acid diathesis and development of urolithiasis. Sometimes detected hyperparathyroidism. Reported individual cases of cardiovascular disease and heart failure. Rarely seen spotted retinal degeneration. Approximately 1% of malignant degeneration of bone occurs with the development of osteosarcoma.
radiography. The pictures revealed deformation and an increase in bone, as well as the uneven change of bone fracture with alternating sections (resorption) and bone formation (osteogenesis). The border bone destruction often has a tapered shape.
Mandatory study also determine the level of serum alkaline phosphatase, which is in deforming osteitis are much higher than normal.
To identify asymptomatic current processes in other bone scintigraphy can be used. If necessary the neurological research, research fields of view and audiogram. In some cases, performed a bone biopsy.
Osteitis deformans differentiated from hyperparathyroidism, primary bone tumors and metastatic tumors in the bone.
In asymptomatic lesions and small local drug treatment is not carried out. When the pain prescribe painkillers. To slow the resorption and defective bone formation processes used Miakaltsik, calcitonin, Pamidronic acid, sodium etidronate and fosamax.
The course of treatment Miakaltsik intramuscular injection lasts at least 3 months, intranasally - within 1.5-3 years. Deadline etidronate and FOSAMAX average of six months. The duration of courses of treatment with calcitonin and pamidronic acid may vary. Many of these drugs can cause quite serious side effects, so they should be taken only on prescription.
For patients develop a customized program of exercises, pick a diet with a balanced intake of vitamin D and calcium, prescribe substitution drugs, if necessary.
When hearing loss is selected hearing aids.
Surgical treatment is carried out according to indications in fractures. With the defeat of the joint and the development of arthritis may require joint replacement.