Final answer:
Paget's disease of the bone often presents with symptoms such as bone pain, fractures, and deformities, notably in the pelvis, skull, spine, and legs. Diagnosis is made through imaging studies and elevated blood levels of alkaline phosphatase. It is characterized by abnormal bone remodeling, different from osteoporosis, and generally affects adults over 40.
Step-by-step explanation:
Common Clinical Picture of Paget's Disease of Bone
The common clinical picture of Paget's disease of the bone includes various symptoms, even though some individuals may be asymptomatic. Affected bones could present with bone pain, fractures, and noticeable bone deformities. Specifically, Paget's disease often targets bones in the pelvis, skull, spine, and legs. Abnormalities in the skull bones might lead to headaches and hearing loss. Notably, as depicted in Figure 6.14, normal leg bones are straight, whereas those affected by Paget's disease appear porous and curved due to the disease's effect on bone remodeling.
Diagnosis involves imaging, such as X-rays that reveal bone deformities or areas of bone resorption, and bone scans using a radioactive dye to highlight regions of high bone turnover. Elevated levels of an enzyme called alkaline phosphatase in the blood are a hallmark of the disease. It is crucial to understand that Paget's disease is different from osteoporosis, which involves a reduction in bone mass with a different pattern of bone turnover, and does not feature elevated alkaline phosphatase levels.
Paget's disease typically manifests in adults over age 40 and is characterized by the disruption of the normal bone remodeling process. Initially, osteoclast activity increases, leading to more bone resorption than formation. This is followed by compensatory but disorganized and inadequate bone formation by the osteoblasts, making the new bone weak and prone to fractures.