Paget's disease of the bone - Revision history

Sarah: /* Microscopic */

2014-12-27T07:30:02Z

Microscopic

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	==Microscopic==		==Microscopic==
	Features:<ref name=emed_paget>URL: [http://emedicine.medscape.com/article/311688-overview http://emedicine.medscape.com/article/311688-overview]. Accessed on: 25 December 2010.</ref>		Features:<ref name=emed_paget>URL: [http://emedicine.medscape.com/article/311688-overview http://emedicine.medscape.com/article/311688-overview]. Accessed on: 25 December 2010.</ref>
	*Lytic and mixed Paget disease ~~is a~~ cellular, fibro-osseous (bone and fibrous components)		*Lytic and mixed Paget disease are cellular and fibro-osseous (bone and fibrous components)
	*~~Mature~~ Paget disease ~~is sclerotic with~~ thickened bone trabeculae.		*Sclerotic Paget disease has thickened bone trabeculae.
	*Bone matrix has jigsaw-puzzle like pattern.		*Bone matrix has jigsaw-puzzle like pattern.
	**Jigsaw-puzzle pieces each ~ 100-500 micrometres in size (largest dimension).		**Jigsaw-puzzle pieces each ~ 100-500 micrometres in size (largest dimension).

Sarah: /* Microscopic */

2014-12-27T07:29:10Z

Microscopic

← Older revision		Revision as of 07:29, 27 December 2014
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	==Microscopic==		==Microscopic==
	Features:<ref name=emed_paget>URL: [http://emedicine.medscape.com/article/311688-overview http://emedicine.medscape.com/article/311688-overview]. Accessed on: 25 December 2010.</ref>		Features:<ref name=emed_paget>URL: [http://emedicine.medscape.com/article/311688-overview http://emedicine.medscape.com/article/311688-overview]. Accessed on: 25 December 2010.</ref>
	*~~Early~~ Paget disease is cellular ~~and~~ fibro-osseous (bone and fibrous components)		*Lytic and mixed Paget disease is a cellular, fibro-osseous (bone and fibrous components)
	*Mature Paget disease is sclerotic with thickened bone trabeculae.		*Mature Paget disease is sclerotic with thickened bone trabeculae.
	*Bone matrix has jigsaw-puzzle like pattern.		*Bone matrix has jigsaw-puzzle like pattern.

Sarah: /* Microscopic */

2014-12-27T07:18:18Z

Microscopic

← Older revision		Revision as of 07:18, 27 December 2014
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	==Microscopic==		==Microscopic==
	Features:<ref name=emed_paget>URL: [http://emedicine.medscape.com/article/311688-overview http://emedicine.medscape.com/article/311688-overview]. Accessed on: 25 December 2010.</ref>		Features:<ref name=emed_paget>URL: [http://emedicine.medscape.com/article/311688-overview http://emedicine.medscape.com/article/311688-overview]. Accessed on: 25 December 2010.</ref>
			*Early Paget disease is cellular and fibro-osseous (bone and fibrous components)
			*Mature Paget disease is sclerotic with thickened bone trabeculae.
	*Bone matrix has jigsaw-puzzle like pattern.		*Bone matrix has jigsaw-puzzle like pattern.
	**Jigsaw-puzzle pieces each ~ 100-500 micrometres in size (largest dimension).		**Jigsaw-puzzle pieces each ~ 100-500 micrometres in size (largest dimension).

Sarah: /* Images */

2014-12-27T07:02:34Z

Images

← Older revision		Revision as of 07:02, 27 December 2014
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	Image:Paget_disease_of_bone_-_high_mag.jpg \| Paget's disease - bone - high mag. (WC/Nephron)		Image:Paget_disease_of_bone_-_high_mag.jpg \| Paget's disease - bone - high mag. (WC/Nephron)
	Image:Paget_disease_of_bone_-_very_high_mag.jpg \| Paget's disease - bone - very high mag. (WC/Nephron)		Image:Paget_disease_of_bone_-_very_high_mag.jpg \| Paget's disease - bone - very high mag. (WC/Nephron)
			Image:Bone PagetDisease MP2 PA (2).JPG\|Early Paget disease - cellular fibro-osseous lesion osteoclastic resorptive lacunae.(SKB)
			Image:Bone PagetDisease MP2 PA.JPG\|Early Paget disease - Cellular fibro-osseous lesions with less calcified osteoid trabeculae exhibiting some osteoblastic rimming. (SKB)
	</gallery>		</gallery>

Michael at 02:44, 25 February 2014

2014-02-25T02:44:36Z

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	\| Syndromes =		\| Syndromes =
	\| Clinicalhx =		\| Clinicalhx =
	\| Signs = deafness		\| Signs = +/-deafness
	\| Symptoms = bone pain		\| Symptoms = +/-bone pain
	\| Prevalence =		\| Prevalence =
	\| Bloodwork = elevated ALP		\| Bloodwork = elevated ALP

Michael: /* Images */ more

2014-02-25T02:43:54Z

Images: more

← Older revision		Revision as of 02:43, 25 February 2014
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	===Images===		===Images===
	<gallery>		<gallery>
	Image:Paget_disease_of_bone_-_high_mag.jpg \| Paget disease - bone - high mag. (WC/Nephron)		Image:Paget_disease_of_bone_-_intermed_mag.jpg \| Paget's disease - bone - intermed. mag. (WC/Nephron)
	Image:Paget_disease_of_bone_-~~_intermed_mag~~.jpg \| Paget disease - bone - ~~intermed.~~ mag. (WC/Nephron)		Image:Paget_disease_of_bone_-_high_mag.jpg \| Paget's disease - bone - high mag. (WC/Nephron)
			Image:Paget_disease_of_bone_-_very_high_mag.jpg \| Paget's disease - bone - very high mag. (WC/Nephron)
	</gallery>		</gallery>

Michael: +infobox

2014-02-25T02:42:44Z

+infobox

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			{{ Infobox diagnosis
			\| Name = {{PAGENAME}}
			\| Image = Paget_disease_of_bone_-_high_mag.jpg
			\| Width =
			\| Caption = Paget's disease of the bone. [[H&E stain]].
			\| Synonyms =
			\| Micro = bone matrix has jigsaw-puzzle like pattern (jigsaw-puzzle pieces each ~ 100-500 micrometres in size in largest dimension), increased osteoclast activity
			\| Subtypes =
			\| LMDDx =
			\| Stains =
			\| IHC =
			\| EM =
			\| Molecular =
			\| IF =
			\| Gross =
			\| Grossing =
			\| Site = [[bone]]
			\| Assdx = [[fracture of bone]], [[secondary osteosarcoma]]
			\| Syndromes =
			\| Clinicalhx =
			\| Signs = deafness
			\| Symptoms = bone pain
			\| Prevalence =
			\| Bloodwork = elevated ALP
			\| Rads = bony deformity, "sunburst" skull
			\| Endoscopy =
			\| Prognosis = benign
			\| Other =
			\| ClinDDx =
			\| Tx =
			}}
	'''Paget's disease of the bone''' is an uncommon benign disorder of [[bone]] with distinctive radiographic findings.		'''Paget's disease of the bone''' is an uncommon benign disorder of [[bone]] with distinctive radiographic findings.

Michael: create

2014-02-25T02:33:49Z

create

New page

'''Paget's disease of the bone''' is an uncommon benign disorder of [[bone]] with distinctive radiographic findings.

It is unrelated to the [[Paget's disease of the breast]] and [[extramammary Paget's disease]].

==General==
*Benign - unlike [[Paget disease of the breast]].
*Afflicts ~ 3% of population > 55 years old.<ref name=pmid22396921/>
*Leading cause of ''secondary [[osteosarcoma]]''.
*Uncommonly associated with [[giant cell tumour of bone]].<ref name=pmid17437100>{{Cite journal | last1 = Hoch | first1 = B. | last2 = Hermann | first2 = G. | last3 = Klein | first3 = MJ. | last4 = Abdelwahab | first4 = IF. | last5 = Springfield | first5 = D. | title = Giant cell tumor complicating Paget disease of long bone. | journal = Skeletal Radiol | volume = 36 | issue = 10 | pages = 973-8 | month = Oct | year = 2007 | doi = 10.1007/s00256-007-0310-x | PMID = 17437100 }}</ref><ref name=pmid21319038>{{Cite journal | last1 = Karakida | first1 = K. | last2 = Ota | first2 = Y. | last3 = Aoki | first3 = T. | last4 = Akamatsu | first4 = T. | last5 = Kajiwara | first5 = H. | last6 = Hirabayashi | first6 = K. | title = Multiple giant cell tumors in maxilla and skull complicating Paget's disease of bone. | journal = Tokai J Exp Clin Med | volume = 35 | issue = 3 | pages = 112-7 | month = Sep | year = 2010 | doi = | PMID = 21319038 }}</ref>
*[[Diagnosis]] based on radiology.<ref name=pmid22396921/>
*Genetic component - several genes implicated<ref name=omim602080>{{OMIM|602080}}</ref> including ''TNFRSF11A'' ([[AKA]] PDB2)<ref name=omim603499>{{OMIM|603499}}</ref> and ''PDB4''.<ref name=omim606263>{{OMIM|606263}}</ref>

===Clinical===
Presentation:<ref name=pmid22396921>{{Cite journal | last1 = Britton | first1 = C. | last2 = Walsh | first2 = J. | title = Paget disease of bone - an update. | journal = Aust Fam Physician | volume = 41 | issue = 3 | pages = 100-3 | month = Mar | year = 2012 | doi = | PMID = 22396921 | URL = http://www.racgp.org.au/afp/201203/201203britton.pdf }}</ref>
*[[Fracture of bone|Fracture]].
*Bone pain.
*Bony deformity.
*Deafness.
*Incidental finding - radiologic or biochemical.

Serology:
*Elevated ALP.

Clinical features - mnemonic ''PANICS'':<ref>URL: [http://www.medicalgeek.com/orthopedics/2743-orthopedics-mnemonics.html http://www.medicalgeek.com/orthopedics/2743-orthopedics-mnemonics.html]. Accessed on: 30 April 2012.</ref>
*'''P'''ain (bone).
*'''A'''rthralgia and '''A'''LP elevated.
*'''N'''erve compression - deafness.
*'''I'''ncreased bone density.
*'''C'''ardiac failure (high output) - due to AVM formation in bone.
*'''S'''unburst skull on X-ray.

===Stage===
Classically divided into three phases:<ref name=emed_paget>URL: [http://emedicine.medscape.com/article/311688-overview http://emedicine.medscape.com/article/311688-overview]. Accessed on: 25 December 2010.</ref><ref>URL: [http://radiopaedia.org/articles/paget-disease-of-bone-1 http://radiopaedia.org/articles/paget-disease-of-bone-1]. Accessed on: 25 December 2010.</ref>
#Lytic (predominantly osteoclasts).
#Mixed lytic (osteoclastic) and blastic (osteoblastic).
#Sclerotic (burned-out).

==Microscopic==
Features:<ref name=emed_paget>URL: [http://emedicine.medscape.com/article/311688-overview http://emedicine.medscape.com/article/311688-overview]. Accessed on: 25 December 2010.</ref>
*Bone matrix has jigsaw-puzzle like pattern.
**Jigsaw-puzzle pieces each ~ 100-500 micrometres in size (largest dimension).
*Increased osteoclast activity.
**Osteoclast = macrophage that reabsorbs bone matrix.

===Images===
<gallery>
Image:Paget_disease_of_bone_-_high_mag.jpg | Paget disease - bone - high mag. (WC/Nephron)
Image:Paget_disease_of_bone_-_intermed_mag.jpg | Paget disease - bone - intermed. mag. (WC/Nephron)
</gallery>

==See also==
*[[Bone]].
*[[Paget's disease of the breast]].
*[[Extramammary Paget's disease]].

==References==
{{Reflist|2}}

[[Category:Bone]]
[[Category:Diagnosis]]