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Paget's Disease |
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Paget's disease of bone is a common disease of
unknown cause affecting bones in the elderly.
In Paget's disease there is excessive uncontrolled resorption of bone by large
abnormal multinucleated osteoclasts.
Excessive osteoclastic erosion occurs in
waves, leading to localized destruction of trabecular and cortical bone; each
wave of bone destruction is followed by a vigorous but uncoordinated
osteoblastic response, producing new osteoid in an attempt to fill the defects
left by the osteoclasts.
Both the osteoclastic erosion and the osteoblastic
response are random, haphazard and unrelated to the functional stresses on the
bone. As a result, the bone architecture is greatly distorted and, although
there may be an increase in bone bulk, it is paradoxically weaker than normal.
New bone formed as a repair attempt by the osteoblasts often has the
characteristic woven, non-lamellar pattern indicative of rapid reparative
deposition. Disruption of the bone architecture is followed by progressive
fibrosis of the marrow spaces.
Paget's disease may be widespread, affecting many bones, or confined to one area
in a single bone (monostotic Paget's disease). Its cause is unknown, but a viral
infection of osteoclasts has been postulated because of the observation that
some abnormal osteoclasts in Paget's disease contain paracrystalline inclusions
resembling paramyxovirus. However, no virus has been shown using sophisticated
molecular techniques. |
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We give here simplified and accurate information about the disease
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