Paget's disease of bone assessment and treatment planning
Paget's disease of bone affects the normal renewal and repair of bone. Over time, the affected bone can become enlarged, weakened, painful or more vulnerable to deformity and fracture.
Paget's disease is often found by chance on a blood test, X-ray or scan. Specialist assessment helps clarify whether monitoring or treatment is needed.
Paget's disease changes the way bone is broken down and rebuilt.
Bone is living tissue that is constantly renewed. In Paget's disease, this process becomes disorganised in one or more areas of the skeleton. The new bone may be larger, structurally abnormal and weaker than normal bone.
Many people with Paget's disease do not have obvious symptoms, and the condition may be discovered during investigations for another reason. When symptoms occur, they may include bone pain, joint pain, deformity, fracture, hearing problems or nerve-related symptoms depending on which bones are affected.
- Assessment of suspected or confirmed Paget's disease of bone
- Review of alkaline phosphatase blood results, X-rays and scan findings
- Investigation of bone pain, deformity, fracture risk or nerve symptoms
- Treatment planning, monitoring and bisphosphonate advice where appropriate
What Paget's disease can look like
Paget's disease may affect one bone or several bones. Commonly affected areas include the pelvis, spine, skull, shoulders and legs. Symptoms vary depending on the bones involved and how active the condition is.
Bone pain
A deep, aching bone pain may occur in the affected area, sometimes worse at night or at rest.
Joint pain
Changes in nearby bone structure can affect joints and contribute to arthritis-like symptoms.
Bone enlargement
Affected bones may become enlarged or misshapen over time, depending on the site involved.
Fracture risk
Pagetic bone can be structurally weaker and may be more vulnerable to fracture.
Nerve symptoms
If enlarged bone compresses nearby nerves, symptoms may include tingling, weakness or hearing changes.
Incidental finding
Some people have no symptoms and are diagnosed after a blood test, X-ray or scan for another reason.
Why Paget's disease happens
The exact cause of Paget's disease is not fully understood. It tends to become more common with age and can sometimes run in families, suggesting that genetic factors may play a role.
Paget's disease is not the same as osteoporosis, although both are bone conditions. Paget's disease affects the renewal and repair of bone in specific areas, while osteoporosis involves reduced bone strength more generally across the skeleton.
How Paget's disease is assessed
Assessment may include a blood test to check alkaline phosphatase, which can be raised when bone turnover is increased. X-rays or bone scans may be used to identify which bones are affected.
A specialist review helps interpret these results in context, assess whether symptoms are due to Paget's disease and decide whether treatment, monitoring or further investigation is needed.
Management depends on symptoms, activity and the bones affected
Some people with Paget's disease need treatment to relieve symptoms or control active disease. Others may need monitoring if the condition is not causing symptoms or complications.
Treatment planning should consider pain, fracture risk, joint involvement, nerve symptoms, calcium and vitamin D status, previous investigations and whether surgery is being considered for an affected bone or joint.
Related treatments and services
Paget's disease treatment depends on symptoms, blood test results, scan findings, affected bones and the risk of complications. Professor Keen can assess whether monitoring, treatment or longer-term bone health planning is most appropriate.
A specialist consultation for Paget's disease of bone
Professor Keen will review your symptoms, blood test results, X-rays, scan findings, previous fractures, medication history, family history and any joint, nerve or hearing-related symptoms.
The consultation can help confirm whether Paget's disease is active, whether symptoms are related to the condition and whether treatment or monitoring is the most appropriate next step.
Paget's disease questions
Common questions from patients with suspected or confirmed Paget's disease of bone.
Is Paget's disease the same as osteoporosis?
No. Paget's disease affects the normal renewal and repair of bone in one or more specific areas. Osteoporosis is a condition where bones generally become weaker and more fragile.
What bones are commonly affected?
Paget's disease can affect one bone or several bones. Common sites include the pelvis, spine, skull, legs, shoulders and other large bones.
How is Paget's disease diagnosed?
Diagnosis may involve blood tests, X-rays and scans. A specialist review helps interpret the results, assess disease activity and decide whether treatment is needed.
Can Paget's disease be treated?
Yes. There is no cure, but treatment can help control symptoms and disease activity. Bisphosphonate medicines are commonly used when treatment is needed.
Do all patients need treatment?
Not always. Some patients without symptoms may be monitored. Treatment decisions depend on symptoms, disease activity, bones affected, risk of complications and wider medical factors.
Arrange a specialist Paget's disease appointment
If you have suspected or confirmed Paget's disease, raised alkaline phosphatase, bone pain, abnormal imaging or uncertainty about treatment, please contact the practice to arrange an appointment.
Contact details
For private appointments and general enquiries, please contact the office.