How to Diagnose Paget's Disease

Paget's disease is a localized bone disease in which bone formation and resorption are increased. The bone structure becomes structurally disorganized, causing it to be larger and weaker than normal. Paget's disease is a common bone disorder of the elderly, although up to 90 percent of patients are asymptomatic. The course of this disease has three phases: lytic, mixed and sclerotic. The following steps will show how to diagnose Paget's disease.

Instructions

• 1

  Detect Paget's disease incidentally. Most cases of Paget's disease are discovered upon examination for an unrelated matter. The most common symptom, when any exist, is bone pain.

• 2

  Observe less common symptoms of Paget's disease. These can include congestive heart failure, hearing loss, pathologic fractures and weakness.

• 3

  Perform specific tests for Paget's disease. An elevated level of Bone Specific Alkaline Phosphatase is the most specific laboratory result for Paget's disease. Other findings include elevated levels of deoxypyridinoline, C-telopeptide and N-telopeptide in the urine.

• 4

  Use radiographs to find several relatively specific signs of Paget's disease. The boundary between healthy and disordered bone may show as a classic V-shaped pattern in the long bones. A thickened iliopectineal line may be present in the pelvis and the skull may have a characteristic "cotton wool" pattern.

• 5

  Examine abnormal bony architecture histologically. The lytic phase consists of osteolysis, which is soon followed by the mixed phase marked by an accelerated deposit of bone in a random manner. The sclerotic phase consists of accelerated bone formation with an increase in osteoblastic activity.