Paget’s Disease
Instructions:
1) Describe patient history and symptoms
2) Describe patient population affected, frequency
3) Description of modality used including view methods, positioning, techniques
4) Advantages and disadvantages over other modalities
5) Review of image findings ( can include other supporting test results – labs, etc)
6) Diagnosis and discussion of pathology
7) Treatment options
8) Prognosis
9) References( using APA format)
Solution
Paget’s Disease
Description of patient history and symptoms
Paget’s disease mainly interferes with the patient’s normal bone recycling process. As such, the new bone tissue slowly replaces the old bone tissue. Over a period, the disease causes the various bones affected to be weak and misshapen. In reference to Deaconu, et al., (2015) Paget’s disease commonly manifests in the pelvis, spine, and skull. The main symptoms can include hearing loss, pinched nerves across the spine, and broken bones.
Description of population affected and frequency
The risk of getting the bone diseases is heightened as the person ages. Further, the bone disease has been deemed as hereditary, and one can have increased risk in the instance that the member has the disorder. As such, from the analysis of Deaconu, et al., (2015) the populations that can be affected include:
- Individuals who are older than 40
- Men are affected at a higher rate than women
- The disease is common among individuals from England, Scotland, Greece as well as regions with European immigrants. However, the ailment is uncommon in the Asian and Scandinavian regions
Description of modality used including view methods, positioning, techniques
Due to the asymptomatic nature of the Paget’s disease, in most instances, it is discovered accidentally. The prospect of increased levels of serum alkaline phosphates (ALK-P) of strange origin or in some instances upon radiography it is evident. In most instances, individuals with Paget’s disease have increased serum ALK-P that is in a heightened manner and is not inclusive of the diagnosis (Ralston, 2013). Thus, to view the full extent of the ailment coupled with positioning, radiography coupled with bone scintigraphy are undertaken. In most instances, bone scintigraphy is preferred due to sensitivity in the identification of the Paget lesions.
Advantages and disadvantages over other modalities
The use of the bone scintigraphy is advisable over the other processes. As such, the use of the approach presents the main advantage of accuracy and sensitivity in the identification process. The modality exudes an effective approach towards identifying the Paget lesions. On the other hand, the main disadvantage of the approach is the rigorous procedures that the patients have to endure in the treatment process.
Review of the image findings
Descriptive epidemiological research reveals the preference of the ailment at 4.6%. As an ailment that is at a higher rate in the United Kingdom as compared to other nations, the prevalence of the disease has been reducing at a steady rate (Ralston, 2013). As a clear example, the prevalence rate as at 2000 in Britain was at 6%. As another finding, the prevalence in individuals over 55 was at 0.3% across England (Ralston, 2013). Nonetheless, across New Zealand, the prevalence rate was reduced by over 50% as at 20007.
Diagnosis and description of pathology
In the physical example, the medical practitioner will examine the areas of the body that are causing pain. As such, the doctor may implement X-rays coupled with blood tests. Through the dualistic approach, effective diagnosis of the Paget’s disease of the bone can prevail (Deaconu, et al., 2015). In the imaging tests, the disease can be revealed through:
- X-rays: X-ray images of the bone can reveal the areas of bone re-absorption, enlargement of bones and any deformities
- Bone scan: in the bone process, an injection of radioactive material is administered, which reveals the spots where the disease has manifested.
Treatment options
Treatment of the ailment aims towards eradicating the symptoms and reduction of bone turnover with a long-term aim of inducing remission for the prevention of both progression and complications. Therefore, the use of calcitonin coupled with bisphosphonates is effective in inhibiting osteoclastic bone resorption (Deaconu, et al., 2015). As such, analgesics coupled with nonsteroidal anti-inflammatory medication can be used to image the diverse symptoms. Surgery can also be implemented that is inclusive of joint replacement coupled with fracture fixation.
Prognosis
Individuals diagnosed with the
ailment have bone pain, overgrowth of bone in the skull that leads to hearing
loss, and in some instances, the bone can weaken and bend. The prognosis for
the approach is towards prevention of excessive hemorrhage in the individuals
with the ailment would undergo elective orthopedic surgery that comprises of
Pagetic bone (Ralston, 2013). Treatment should be an undertaken to ensure that
prevention of the skeletal deformities such as becoming bowlegged and
osteoarthritis in the hip or knee of the individual. Further, early treatment
should be undertaken in the asymptomatic Paget’s disease patients to reverse
the lesions and minimize the skeletal deformity.
References
Deaconu, C., Groşeanu, L., Iorgoveanu, V., Borangiu, A., Opriş, D., Săulescu, I., … & Abobului, M. (2015). A5. 4 Prevalence of comorbidities in Paget’s disease of the bone a single center report. Annals of the Rheumatic Diseases, 74(Suppl 1), A48-A48.
Ralston, S. H. (2013). Paget’s Disease of Bone. New England Journal of Medicine, 368(7), 644-650.
