Paget Disease of Bone : Clinical Features

Comments:
Clinical Features of Paget Disease of Bone (PDB) (continued from the previous image): Bone overgrowth can compress vital structures and cause neurologic complications. Hearing loss due to cochlear damage is common in PDB (9% of cases). Compression at the base of skull can cause basilar invagination, cerebellar dysfunction and obstructive hydrocephalus. Entrapment of thoracic or lumbar nerve roots may lead to paraparesis or paraplegia.

Secondary sarcomas develop in 0.3-0.5% of patients and can present with pain and a soft tissue mass. Increased blood flow to the affected bone brought on by high metabolic activity can increase cardiac output and lead to high-output cardiac failure. This is, however, an extremely rare complication.

This photograph shows bilateral bowing of tibia (sabre tibia) due to bone overgrowth in a patient with PDB. Image courtesy of: Dr. Ibrahim Zardawi; used with permission.