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Pathology
Chronic disorder of bone remodelling with excessive breakdown and formation of bone causing painful, misshapen bones and fractures with altered bone architecture
Aetiology
Elderly population, male>female.
Signs
Increased head size, sabre tibia, warmth over affected area
Symptoms
Bone pain. hearing loss (due to compression of CNVIII)
Investigations
Bloods: Increased ALP, Normal calcium and phosphate
Urine: Increased hydroxyproline (indicator of bone turnover)
Imaging: X-Rays show mixed osteolytic and sclerotic areas of bone affectedis.Treatment
Medical: Bisphosphonates, calcitonin
Surgical: Fracture management
Prognosis
Poor prognosis with cardiac involvement
Fractures, high-output cardiac failure, osteosarcoma, hypercalcaemia, immobility, hearing loss, loose teeth
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Key References
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