Complications

Paget's disease of bone can sometimes lead to further problems.

The main complications are outlined below.

Broken bones

Bones affected by Paget's disease of bone tend to be more fragile than normal bone and are more likely to break (fracture) even after a relatively minor injury.

Signs of afracture include:

• sudden, severe pain
• swelling or tenderness around the injured area
• bleeding, if the bone has damaged the tissue and skin

It's not clear whether bisphosphonate medication helps prevent or treat fractures. If you break a bone, you may need surgery to align the broken bones so that they heal correctly.

Bone deformities

It's common for Paget's disease of bone to affect the appearance of affected bones.

For example, the condition can cause:

• enlarged or misshapen bones
• the legs tocurve outwards (bow legs)
• the spine to curve to the sides ( Scoliosis )
• the upper back to becomevery hunched over ( kyphosis )

As with fractures, it's not clear whether bisphosphonates can help prevent deformities. If they do occur, surgery may be carried out to correct them.

Hearing loss

If Paget's disease of bone affects the skull,there's a significant risk that it could lead to permanent hearing loss and possibly total deafness.

This can occur as a result of damage to the bonesor nerves that connect the ears to the brain.

It's notknown whether treating Paget's disease of bone helps reduce the risk of losing your hearing, but treatment is usually recommended if the condition is affecting your skull.

Too much calcium in the blood

In rare cases, the increased cycle of bone renewal in Paget's disease of bone can result in calcium building up in the blood. This is known as hypercalcaemia.

It usually only occurs in people whohave been confined to bed after an operation or a fracture.

Symptoms of hypercalcaemia can include:

• extreme tiredness
• depression
• drowsiness
• constipation
• new or worsening bone pain

Hypercalcaemia can be treated using medicines to lower blood calcium levels and slow down bone regeneration.

Heart failure

The new bone that forms in people with Paget's disease of bone often contains more blood vessels than normal bone, which can mean the heart has to work harder to pump blood around the body.

Very occasionally,the heart may not be able to pump enough blood around the body. This is known as heart failure .

Symptoms of heart failure can include:

• shortness of breath
• extreme tiredness and weakness
• swelling in the legs, ankles and feet ( oedema )

Heart failure can be treated with medication and in some cases heart surgery. It's estimated to affect between 1 in 100 and 1 in 1,000 people with the condition.

Symptoms ofbone cancer are similar to those of Paget's disease of bone. They can include:

• bone pain
• swelling around the affected bone
• a lump in the affected bone

Osteosarcoma is a very serious type of cancer that can spread to other parts of the body quickly. But if it's caught early enough, it may be possible to cure it by removing the affected bone.

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