History
Patients may present with a variety of symptoms including:
- Bone pain
- Bone deformity
- Pathological fracture
- Deafness
- Osteoarthritis
- Incidental finding
Examination
- Most patients have no abnormalities
- Where there is bone deformity, this usually affects tibia, skull or femur
Investigations
- Routine biochemistry (raised ALP, with otherwise normal LFT, calcium and U&E)
X-ray pelvis and lumbar spine ( abnormal in 70% of patients)
When to refer
Patients suspected to have Paget’s should be referred for evaluation to determine if antiresorptive treatment is indicated
Initial management
Treat on a symptomatic basis pending clinic review.
