Orthonotes
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Paget’s Disease of Bone

Focal disorder of accelerated bone turnover: osteoclastic resorption followed by disorganized osteoblastic formation → enlarged, weak, vascular bone. Common sites: pelvis, spine, femur, tibia, skull; often polyostotic; usually age >55. Symptoms: bone pain, deformity (tibia/femur bowing), pathological fractures, skull enlargement, hearing loss; many asymptomatic. Labs: ↑ALP with normal Ca/PO4 (unless immobilization or hyperparathyroidism). Imaging: X‑ray with mixed lytic–sclerotic changes and bone enlargement; bone scan shows extent; CT/MRI for complications. Complications: fracture, deformity/arthritis, cranial neuropathies, high‑output cardiac failure (rare), osteosarcoma (~1%). Treatment: Nitrogen bisphosphonates (zoledronate) for pain, high ALP, or planned surgery; orthopaedic correction for deformity/arthritis.

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Focal disorder of accelerated bone turnover: osteoclastic resorption followed by disorganized osteoblastic formation → enlarged, weak, vascular bone. Common sites: pelvis, spine, femur, tibia, skull; often polyostotic; usually age >55. Symptoms: bone pain, deformity (tibia/femur bowing), pathological fractures, skull enlargement, hearing loss; many asymptomatic. Labs: ↑ALP with normal Ca/PO4 (unless immobilization or hyperparathyroidism). Imaging: X‑ray with mixed lytic–sclerotic changes and bone enlargement; bone scan shows extent; CT/MRI for complications. Complications: fracture, deformity/arthritis, cranial neuropathies, high‑output cardiac failure (rare), osteosarcoma (~1%). Treatment: Nitrogen bisphosphonates (zoledronate) for pain, high ALP, or planned surgery; orthopaedic correction for deformity/arthritis.
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Question 1

What is the most common symptom of Paget's disease of bone?

Question 2

Which of the following imaging findings is characteristic of the mixed phase of Paget's disease?

Question 3

In Paget's disease, which lab finding is typically elevated?

Question 4

Which genetic mutation is most commonly associated with familial cases of Paget's disease?

Question 5

Which of the following bones is least likely to be affected by Paget's disease?

Question 6

What is a potential rare complication of Paget's disease?

Question 7

Which treatment is primarily used for managing pain in Paget's disease?

Question 8

What age group is primarily affected by Paget's disease?

Question 9

Which of the following is a classic radiological feature of Paget's disease in the skull?

Question 10

What is the most common demographic group affected by Paget's disease?