for patients with Paget's disease should include monitoring serum
alkaline phosphatase (SAP) annually in untreated patients with mild
cases. In treated patients, SAP is usually monitored every 3-4 months.
Alternatively, urinary collagen cross-link measurements can be used.
Annual x-ray studies should be done when osteolytic disease is present,
to determine if treatment has caused healing of the pagetic lesions,
or if there is significant progression of the lesions.