Introduction: Pagets disease of bone (PDB) is the second-most-common metabolic bone disease, after osteoporosis, affecting about 3% of the population at age over 40 years. This disease is characterized by excessive and abnormal bone remodeling due to increased bone resorption followed by disorganized bone formation.
This paper will include a case report and a review of PDB epidemiology and pathophysiology, complications and clinical findings, indications for treatment, and the drugs currently available to treat this condition.
Case report: Sixty four years old woman, who addressed to our department in March 2011 for chronic left hip and low back pain, with insidious onset which has increased over time, fatigue, headaches attacks with occipital localization associated with dizziness and intracranial pressure. The evaluation of phospho-calcic metabolism showed normocalcemia, hypophosphatemia, normocalciuria, hyperphosphaturia, normal serum parathyroid hormone level, 25-hydroxy vitamin D level decreased (19 ng/ml) and alkaline phosphatase level increased (572 U/l). Bone scintigraphy revealed intense uptake of radiopharmaceutical in the left femur. The bones X-rays and computed tomography of the left femur showed marked thickening and sclerosis of cortical bone with inhomogeneous ossification of bone structure, osteolysis and small subchondral cystic lesions. Medical treatment was initiated with alendronate, calcium and vitamin D, with favorable evolution during the next months. Long term follow-up is required for monitoring related complications.
Keywords: Pagets disease of bone, bone resorption, alendronate