Paget’s Disease: Complications

Abnormal Osteoclasts cause excessive bone turnover -> Incr bone resorption, Incr (abnormal) bone formation



MSK

 • Deformed bones puts abnormal pressure on joints over time -> Osteoarthritis

 • Lytic lesions make bones weaker and more susceptible to breakage -> Pathologic fractures

Renal

 • Incr Bone resorption, Incr renal [Ca2+] load, Incr urine [Ca2+] -> Nephrolithiasis (Kidney Stones)

Cardiac

 • Extensive vascularity leads to high cardiac output -> Congestive Heart Failure (CHF) / Cardiomegaly

Neurological 

 • Disorganized growth of bone in vertebral column may narrow the vertebral canal & compress spinal nerve roots or the spinal cord itself -> Myelopathy or radiculopathy

 • Skull expansion causes narrowing of the foramina through which cranial nerves run, compressing the cranial nerve palsies -> Cranial Nerve Palsies

 • Disordered remodeling of middle ear bones causes middle ear dysfunction -> Conductive hearing loss



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