The potential for complications will depend on which bones are affected by Paget’s disease. Complications may require medical or surgical intervention.
Examples of complications arising from the involvement of specific bones:
- Skull. Paget's in the skull can cause headaches, hearing loss, ringing in the ears and a change in shape and/or size of the skull (i.e. enlarged head, wide forehead).
- Spine. Paget's in the spine can lead the affected vertebrae to become enlarged and deformed which can cause curvature of the spine, pain, and pressure on nerve roots with tingling, weakness and numbness in the legs.
- Femur. Paget's in the femur (thigh) can cause local pain at the site of the Paget's disease or related to osteoarthritis of the hip joint. Fissure (partial) fractures in the bone may lead to a complete fracture.
- Pelvis. Paget's in the pelvis may be painful and accelerate osteoarthritis in the hip joint.
- Shin. When the lower leg is affected the bone may feel warm, be painful and it may bow. Osteoarthritis may develop in the knee joint and fissure fractures may occur possibly leading to complete fracture.
Deformity: Paget’s disease can cause bone to become enlarged and misshapen. For example, if the skull is affected, the enlarged bone is sometimes first noticed when the individual becomes aware that their head is larger and their forehead may be wider than normal. Long-standing disease over many years may cause the weight-bearing bones of the leg to develop a bowing deformity.
"Bone Deformity in Paget’s Disease" an article by Dr D. Hosking can be found in our Member's Area. The photos below show examples of deformity in the arm and the lower leg due to Paget's disease.
Deafness: If the skull is involved, hearing loss can occur.
Fracture: There is an increased risk of fracture, particularly in the long bones of the arm and leg. Fractures may initially be incomplete, (stress fractures or fissure fractures), which are at high risk of complete fracture. Fissure fractures predominantly, but not exclusively, affect weight-bearing bones, such as the thigh bone (femur).
Osteoarthritis: Paget’s disease can predispose to the development of osteoarthritis at adjacent joints. You can read an article by Dr S. Tuck,"Paget's and Osteoarthritis" in our Member's Area.
Neurological complications: Neurological complications can occur, often because of bony overgrowth leading to compression. For example, enlargement of vertebrae in the spine can produce pressure on nerves causing pain, leg weakness or sciatica.
Increased vascularity: Should the bone fracture or surgery be undertaken, active Paget’s disease has the potential to result in excessive blood loss. This is because blood flow increases to areas where Paget’s disease is active.
Heart disease: Paget’s disease does not directly affect the heart but if it is in many bones, is highly active and uncontrolled, the heart may have to work harder to pump extra blood to the affected bones. Whilst heart failure due to this increased blood flow has been reported, it is extremely rare.
Osteosarcoma: An unusual and very rare complication of Paget’s disease is a type of bone cancer, called osteosarcoma. This occurs in less than 1:1,000 people with the disease. Members of the Paget's Association can login to the member area to read an article by experts in Norwich and read about Allan Reid who developed this rare condition. You can also contact our nurse helpline: [email protected] 0161 7994646 or 07713568197. The Bone Cancer Research trust also has information on their website.