Diagnosis

Paget's disease of bone can be diagnosed with a blood test and an X-ray or scan.

These are outlined below.

Blood test

A simple blood test can be carried out to check the level of a substance called alkaline phosphatase (ALP) inyour blood.

People with Paget's disease of bone often have raised levels of ALP, although some people with the condition have a normal ALP level and a high level can alsobe caused by some other conditions.

An X-ray or scanis therefore also needed to confirm the diagnosis.

X-ray and bonescan

An X-ray can show whetheryour bones have become enlarged as a result of Paget's disease of bone.

Sometimes a special type of bone scan called scintigraphy may also be carried out to check how much of your body is affected by the condition.

For this scan, a small amount of a radioactive substance is injected into your blood. This collects in areas where there's a lot of bone renewal taking place.

A special camera known as a gamma camerais then used to detect the radiation andhighlight affected parts of the body.

Further tests

Further tests are usually onlyneeded if you have signs of more severe Paget's disease of bone or your doctor thinks there's a chance you could have bone cancer (although this is very rare).

In these cases, you may be advised to have a:

• bone biopsy a sample of bone isremoved under anaesthetic so it can be looked at in detail
• computerised tomography (CT) scan a series of X-rays of the affected bone are taken tocreate a detailed three-dimensional image
• magnetic resonance imaging (MRI) scan a type of scan where a strong magnetic field and radio wavesare used to create an image of the affected bone