Professional Documents
Culture Documents
DR.HARI PRASATH P
1ST YEAR POST GRADUATE
INTRODUCTION
UNKNOWN
Occasionally hereditary influence is noted on chromosome 18q
On electron microscopy of bone biopsies has demonstrated nuclear
inclusions,
similar to those found in viral diseases (Paramyxoviridae family) are found
in the highly nucleated osteoclasts
Endocrine and metabolic disturbances are unlikely because despite
extensive involvement , many bones are free of disease
PATHOPHYSIOLOGY
3 Phases:
i) Lytic
ii) mixed Lytic and Blastic
iii) Sclerotic
1
Complications
Fractures and bony deformity
Secondary osteoarthritis ( when pagets disease around a joint)
Neurological complications – nerve root compression and cauda equina
syndrome
Skull involvement- deafness
vertigo
tinnitus
dental malocclusion
basilar invagination
cranial nerve disorders
Sarcomatous degeneration - Osteosarcoma
Increased bone vascularity – high output cardiac failure
SURGICAL COMPLICATIONS:
Highly vascular marrow – Profuse bleeding
Structurally weak bone
Spinal / Epidural Anesthesia may be difficult
Investigations
BISPHOSPHONATES
2nd generation bisphosphonates like Tiludronate, Alendronate, risendronate
produces longer remission at lower doses.
Pamidronate – 30mg IV/day over 3hours for 3days
Zolidronic Acid- 5mg IV over 5 mins
First choice where rapid mineralization is required
in neurological symptoms, severe bone pain, risk of fracture
prior to elective surgery
Vitamin D and calcium supplements