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This librete has taken place for any person who suffered of the disease of Paget of the bone. We wished to explain so much as broad on this condition, how he diagnoses himself and how he can be treated. Unfortunately, we cannot hope to answer all its questions because each one is different, and this librete does not think to replace an individual consultation by a doctor. Near the end of librete you will find directions of the organizations who can offer additional aid, including the information on how making contact with enemy with the campaign of the investigation of arthritis (arc).
Sir James Paget was born in great Yarmouth, Norfolk, and was surgeon in the hospital of the St Bartholomew, London, in by the end of century XIX. He wrote an early and very clear description of the disease that now takes its name. The disease of Paget of entrerrosca was others of its discoveries, but there is no another connection between these two conditions.
In order to understand this that helps to know a little on the normal bone. The bone is one died nonsubstance, inactivates but an alive, active fine weave composed of three main components:
mineral (mainly calcium)
matrix (resistant fibers of the colágeno and other substances, that gives to bone their resistance)
cells: osteoblasts (bone-that forms the cells) and osteoclasts (cells bone-that they erode).
The structure of the normal bone is demonstrated in picture 1. Changes of the bone constantly. ' old ' the bone is cleared continuously by the action of the cells of osteoclast. It is replaced by the new bone – done by the cells of osteoblast. This volume of sales or renovation of the bone carefully is balanced. If he were not, you could suffer of the bone ' tires ' (something like fatigue of the metal in old machines). If it happened that its bones they would be more probable to break itself.
The disease of Paget affects growth of the bone. The abnormality happens in the cells of bone. The process of the loss of the regular bone and the formation, orders are interrupted. The cells of bone increase of number, get to be greater and also they get to be more active. The volume of sales of the bone increases in up to forty times, and the new bone is abnormal in form and structure. It is also weaker than generally. The increasing activity of the cells of bone also increases the blood crosses the bone. The bones that possible are more commonly affected demonstrate in picture 2.
The disease of Paget is not rare. It is commonest of the United Kingdom and the countries in where a great amount of British people has emigrated in the past. It is more probable to affect older people. In the United Kingdom near 5 people in excessive the 100 the age of 50 has disease of Paget in a certain piece of the skeleton, although she is often inadvertent and it can not cause no symptoms. For a certain reason, the disease of Paget is still more common in Lancashire where up to 8 percents of people on 50 they have the disease. One more younger people or non-white are less probable to have Paget, although she can happen in any race.
At the moment, the cause of the disease of Paget of the bone is not known. Due to the racial and geographic pattern we finished mentioning, some doctors we have concluded who the disease can be inherited. It is certainly truth that in some families several people affect, but this is absolutely rare. Nevertheless, Paget has been suggested can be caused by a ' slow infection of the virus of the cells of bone. It is called ' is slowed down ' because the virus can place in the cells of early bone in life and to only cause to the disease many years later.
Sometimes there are no symptoms in all. It is absolutely common so that the disease is discovered by accident in a x-ray that has been taken for an absolutely diverse intention. It can similar be detected after an analysis of blood taken for another reason.
The pain is the symptom commonest and it feels generally in the bone. The disease of Paget can be associated sometimes to osteoartritis in the joints surrounds and this can be painful. The increasing blood crosses the bone, that is a characteristic of the disease of Paget, also stimulates the fibers of the nerve in the bone that send signals of the pain. Due to the increasing flow of the blood, the parts of the body affected by the disease of Paget can feel unusually I warm up to the tact, specially if the bone is near the skin, for example, in shin.
The bone that is affected by the disease of Paget extends and can cause the deformity due to the activity disorganized of the cell. Any bone in the skeleton can be affected but most common they are the pelvic bones, the spine, the bones of the thigh and shin, and the skull. The long bones can curve, so that some people can finish for above with a leg with effectiveness shorter than the other.
Although the bone affected by this condition is extended generally, been weaker than and is generally more probable to break itself than the normal healthy bone. Luckyly, nevertheless, the bone cures in the same way that like normal bone.
When the bone of Pagetic is extended can express the next nerves sometimes. This can happen in the skull, where it can cause deafness, or in the spine, that can lead to the weakness and to hum in the legs.
If the disease reaches to the end of the bone, can lead to arthritis in the joint. This one is just as osteoartritis, and can cause to pain and stiffness in the change of the joint (it see librete of the arc 'Grain De Bali').
People with the disease of Paget have an increasing risk to develop gout. Gout cause pain and the swelling in a joint, often the joint of the big toe. If this happens generally the treatments for gout they are effective (it see librete of the arc 'Grain De Bali').
When the disease of the Paget is very extensive the increasing blood crosses the bone can put a tension in the heart. Luckyly, with newest, more effective treatments for this complication of Paget are seen rarely nowadays.
A very small number of people with the disease of Paget of many years the tumors can become the bone, that can sometimes be cancerous. The first samples of this are increasing pain and swelling in the site of the tumor. This is luckyly a very rare complication.
His doctor will have listened to his symptoms and he will have examined to him. If the bone is deformido of a way that is typical of the disease, it is a easy diagnosis. Often, nevertheless, the x-rays and the analyses of blood will be necessary to confirm it.
Sometimes the doctor will recommend an exploration of the bone of the isotope. This one is the most effective way to establish clearly where it is the bone of Pagetic and how he is active is. A very small dose of the radioactive isotope (a radioactive substance that can be detected by the exploration of the bone) is injected in a vein and later the whole skeleton explores several hours more ahead. The radioactive material happens quickly of the body in tinkles it. An exploration of the isotope is important because it will demonstrate how many bones are affected by the disease.
Once the diagnosis has become, they will refer to most of the patients a clinic of the specialist for the burden and the treatment.
Paracetamol and/or the antiinflammatory drugs no-non-steroidal (NSAIDs) can help to reduce the pain in some people although they are not always very effective. The simple measures are sometimes useful. If, for example, a leg has been used excessive respect with effectiveness because the bones of the thigh and shin have grown curved, a group urbanized in the shoe can reduce the sensation of ' lop-sidedness'-sidedness'.
The treatment of the causes of the disease of Paget will
be generally with a called drug group bisphosphonates, that is very effective.
They act mainly in osteoclasts (the cells bone-that they erode)
to delay the fast bone
volume of sales. The low option between
pamidronate, one drug that is injected in a vein, and two oral drugs,
risedronate and tiludronate. Pamidronate occurs like series of the weekly magazine or the injections
fortnightly (6 altogether) or, in some centers, like single injection
that can be repeated after 6 months in case of necessity. The
advantage of the injection is that the drug is absorbed everything in
the body. Risedronate is a course
of two months of tablets and tiludronate is a course of three months. Some people can prefer
tablets to the injections and the option is available. Other
courses can be given in case of necessity.
The pain in the bone is often released in the term of 3–6 months and sometimes more quickly than this. Most of people it has few indirect effect of drugs, although of pamidronate the causes once in a while influenza-like the symptoms that last 1–2 days, and risedronate and tiludronate can cause indigestión sometimes.
The surgery is not normally necessary, but if the bone is broken an operation will be sometimes necessary to fix it. This depends on the type and the severity of the breakage, as with any fracture. If the osteoartritis is from the then disease a new joint it can be treatment – necessary with bisphosphonates before the aids of the operation to reduce the loss of the blood that can happen with this operation. For more information on common surgery of the replacement it sees libretes of the arc 'Grain De Bali' and 'Grain De Bali'.
Still we do not have a treatment for the disease of Paget. Nevertheless, there are the treatments that can suppress the disease, and delay or still it prevents the complications, and the investigation continues that we hoped we will lead to the still more effective treatments.
The campaign of the investigation of arthritis
(arc)
Box 177 of the Po
Chesterfield
Derbyshire S41 7TQ
Telephone: 0870 850 5000
Grain De Bali
As well as the investigation of financing, we produce a
range of informative pamphlets and the free prospectos. Between
in contact with please the direction it arrives for a list of titles.
Taken care of Of Arthritis
Way Of 18 Stephenson
London NW1 2HD
Telephone: 020 7380 6500
Helplines: 020 7380 6555 (10am–4pm
Mon–Fri)
Or freephone: 0808 800 4050 (12pm–4pm
Mon–Fri)
Grain De Bali
Aid of the personal effort of the supplies, a service
of helpline (in both numbers above), and a range of prospectos in
arthritis.
The national association for the relevación of the
disease of Paget
Way Of 323 Manchester
Walkden, Worsley
Manchester M28 3HH
Telephone: 0161 799 4646
www.paget.org.uk
It provides the aid and the information to the people
of the disease of Paget.
| © Campaign 2004 Of the Investigation Of Arthritis | 6031/PG/04-1 |
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