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Demographic and Clinical Features Related to a Symptomatic Onset of Paget’s Disease of Bone
- Source :
- The Journal of Rheumatology. 37:155-160
- Publication Year :
- 2009
- Publisher :
- The Journal of Rheumatology, 2009.
-
Abstract
- Objective.Paget’s disease of bone (PDB) is a focal disorder of skeletal remodeling that can lead to bone pain, deformity, and fractures, but it can often be asymptomatic for a long time. This study investigated which factors may distinguish patients with clinical manifestations from asymptomatic patients.Methods.The study group consisted of 224 patients with PDB referred to our Bone Disease Unit. For all patients, data were collected about clinical and demographic variables and diagnostic procedures. Logistic regression analyses were used to assess the role of recorded variables on the odds of being diagnosed clinically rather than by chance.Results.Among the 124 patients with clinical manifestations leading to the diagnosis (55.4%), 36 subjects complained of bone pain, 32 articular pain, 42 back pain, 2 headache; 9 had fractures in Paget bone, and 3 had bone deformity. In 100 patients (44.6%) PDB was diagnosed by chance. At the multivariate analysis, only the number of bones involved (OR for 1 site increment = 1.18, 95% CI: 1.007–1.402; p = 0.04) acted as an independent predictor for a clinical diagnosis. Some skeletal localizations were associated with a clinical diagnosis: the involvement of lumbar spine (OR = 2.085, 95% CI: 1.024–4.224; p = 0.043) was more likely in symptomatic patients; pelvis and tibia showed a borderline statistical significance. The skull was predictive for asymptomatic PDB.Conclusion.A systematic laboratory screening including serum alkaline phosphatase of an older subject complaining of bone pain, articular pain, or back pain is the sole strategy to improve the diagnostic sensitivity for PDB.
- Subjects :
- Male
medicine.medical_specialty
Bone disease
Immunology
Pain
Asymptomatic
Bone and Bones
Rheumatology
Internal medicine
Epidemiology
medicine
Back pain
Deformity
Humans
Immunology and Allergy
Age of Onset
Bone pain
Aged
business.industry
Middle Aged
Alkaline Phosphatase
Osteitis Deformans
medicine.disease
Surgery
Radiography
Paget's disease of bone
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 14992752 and 0315162X
- Volume :
- 37
- Database :
- OpenAIRE
- Journal :
- The Journal of Rheumatology
- Accession number :
- edsair.doi.dedup.....7b426082cb0078f4de041d8cc06c315e