The Washington University Bone Health Program offers a comprehensive approach to evaluating Paget’s disease of bone and recommending therapy.

What is Paget’s disease of bone?

Paget’s disease of bone is an abnormal increase in both the rate of bone breakdown and bone formation, resulting in bone that is dense, fragile, and easily fractured.

How common is it?

Paget’s disease affects 3-4% of the U.S. population over the age of 50, most frequently occurring between the ages of 50 and 70. It affects 10-20% of people over 60 years of age, which are approximately 3 million individuals. People of European ancestry are more susceptible. In the St Louis area alone, about 20,000 men and women are affected.

What are the symptoms?

Many patients with Paget’s disease are symptom-free, or when symptoms are present, they resemble those of many other diseases. However, pain and symptoms can be severe in some patients. The disease can lead to major deformities of the skeleton and is an important cause of permanent disability. Symptoms include pain, headaches, a hot sensation on the skin over the area of the affected bone, and sometimes deformity of the affected bone.

Every bone in a person’s body, including the skull, is susceptible to Paget’s disease. Consequently, it is not surprising that deafness can occur in untreated patients. The disease usually occurs before the changes in the ability to hear are noticed. Specific tests, such as an audiogram, are essential to detect the early hearing defects associated with Paget’s disease.

How is it diagnosed and treated?

The Bone Health Program offers patients with Paget’s disease an individualized set of diagnostic tests. These may include a bone scan to determine the extent and location of the disease, audiogram to evaluate early loss of high-tone hearing, and measurements of blood enzymes, such as alkaline phosphates, that reflect the extent of the disorder. While the cause of Paget’s disease is unknown, treatment is usually very effective. The Bone Health Program offers the most advanced therapies, using both medication and exercise to relieve pain and to help prevent deformity, fractures, and loss of mobility. Physicians may prescribe drugs given by infusion (Reclast, Aredia), by mouth (Fosamax, Actonel), or nasal spray (Calcitonin).

Is treatment covered under health insurance?

Since the majority of patients with Paget’s disease can be diagnosed and cared for in outpatient facilities, many insurance companies will cover the costs. Please check with your respective carrier for payment allowances and any applicable deductibles. While the Bone Health Program accepts self-referrals, the physicians and nurses work closely with the patient’s personal physician in order to provide comprehensive evaluation, consultation, and timely reports.

To schedule an appointment or refer a patient, please call 314-454-7775. Offices are open Monday-Friday, 8 a.m.-4:30 p.m.

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