Many people who have Paget's disease also develop osteoarthritis. However, this is not the case for all Paget's disease sufferers.
Q. What is osteoarthritis?
A.Osteoarthritis (literally: inflammation of bone and joint) is a condition that can cause a slow progression of joint pain, stiffness, and limitation of movement. Any joint may be involved, but weight-bearing joints such as the hip and knee, as well as the spine (particularly the lumbar spine), are most commonly affected.
Osteoarthritis is caused by changes in the cartilage (a rubbery. Shock-absorbing structure in the joint on the ends of the bone), bone, ligaments, and muscle around the joint. When cartilage is no longer smooth and rubbery, movement puts excessive pressure on the bone, often causing pain.
Osteoarthritis may lead to reduced function and, in some cases, can cause severe disability.
Q. What is the relationship between Paget's disease and osteoarthritis?
A. There are several ways that Paget's disease may
When someone has both Paget's disease and osteoarthritis, how is the
- Paget's disease often alters the normal design of the bone under the cartilage of the joint.
- Paget's disease may cause the long bones (such as the bone of the thigh or leg) to bow (curve) and bend, placing abnormal stresses on the joint.
- Enlargement of the bones in the spine may cause the normal curvature of the back to change./font>
- The pelvis may become softened, causing the hips to develop osteoarthritis and pushing the pelvis inward. If this happens, the person may have difficulty standing.
A. The diagnosis of osteoarthritis in Paget's disease usually includes blood tests and an x-ray. The bone changes found on the x-ray are helpful in diagnosing both osteoarthritis and Paget's disease. Blood and urine tests often help rule out other possible causes of arthritis. There is no easy way to distinguish the two conditions, and the judgment of the physician is critically important in making the decision.
Q. How is the osteoarthritis that is associated with Paget's
A. The goal of therapy for osteoarthritis is to relieve pain and to improve and preserve joint function. The treatment plan can include medications, physical/occupational therapy, mechanical devices, weight control, exercise, and application of heat or cold to reduce muscle spasm. Treatment may also include an injection with a steroid medication (if inflammation is present), other medications that reduce inflammation, and medications that reduce pain. Under certain circumstances, surgery may be needed. The prognosis following hip or knee surgery for osteoarthritis is excellent, even in the presence of Paget's disease.
For patients with Paget's disease, pre-operative treatment with anti-pagetic therapy helps to decrease bleeding and other complications during surgery. If you have Paget's disease and are having surgery on the joint affected by Paget's disease, be sure to discuss pre-treatment with your physician.
Q. What is the overall outcome for people who have both Paget's
disease and osteoarthritis?
A. Since effective therapies are available for both Paget's disease and osteoarthritis, the combination of Paget's disease and arthritis in the same patient need not be severe.
For arthritis information, call the toll-free Arthritis Foundation
(800) 283-7800. In Canada, call The Arthritis Society at (416) 979-7228.