Radiologic observations on bone resorption in Paget's Disease

Doyle, F. H.; Banks, L. M.; Pennock, J. M.

doi:10.1002/art.1780231019

Cited by 29 publications

(3 citation statements)

References 4 publications

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“…It usually involves one bone (monostotic) or a few bones (polyostotic), usually affecting the skull or pelvis, or a vertebra, femur, or tibia [12,13]. Osteolytic fronts progress approximately 1 cm yearly [14]. Cortical thickening (hyperostosis), disorganized coarse trabeculae (osteosclerosis), and bone expansion can be seen.…”

Section: Discussionmentioning

confidence: 99%

Which Theory for the Origin of Syphilis Is True?

Anterić

Bašić

Vilović

et al. 2014

The Journal of Sexual Medicine

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Introduction There are four theories about the origin of syphilis, of which the mostly represented one is the Columbian theory. This theory suggests that syphilis was brought into Europe in 1493 ad by the ship from Caribbean islands. Aim The aim of this study is to test all theories on a sample of 403 skeletons: 135 from prehistory, 134 from antique, and 134 from medieval period and new age from the Dalmatia (Croatia). Methods All skeletons were examined using standard anthropological methods. Paleopathological analysis was performed on each skeleton as well as additional radiographic method on one isolated skeleton. Main Outcome Measures Paleopathological changes on skeletal remains connected with treponematosis. Results Paleopathological analysis revealed one skeleton from the antique period (second to 6th century ad) that exhibited skeletal markers similar to those described in one clinical case in which congenital syphilis was confirmed by a Wasserman reaction. Skeletal remains of this person were examined macroscopically and radiographically, and the differential diagnostics eliminated other considered pathologies as well as trauma. Conclusions The finding of skeletal markers of syphilis on a skeleton from the antique supports the theory of pre-Columbian syphilis origin.

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Section: Discussionmentioning

confidence: 99%

Which Theory for the Origin of Syphilis Is True?

Anterić

Bašić

Vilović

et al. 2014

The Journal of Sexual Medicine

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“…This issue is of particular importance as the majority of patients are asymptomatic. Based on the fact that untreated pagetic lesions may expand progressively with a reported rate of about 1 cm/year,27 some experts advocate the use of bisphosphonates in asymptomatic patients with lesions at sites that are likely to cause complications, such as skull, spine, weight bearing long bones, adjacent to large joints, and jaw.…”

Section: Controversy On the Use Of Bisphosphonates In Treating Paget’mentioning

confidence: 99%

Current perspectives on bisphosphonate treatment in Paget’s disease of bone

Wat¹

2014

TCRM

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Paget’s disease of bone is a chronic metabolic bone disease with focal increase in bone turnover. The exact etiology of the disease is uncertain, although genetic and environmental factors are believed to be important. Bisphosphonate is the main class of medication being used to control disease activity via its antiresorptive effect. This review discusses the controversies concerning the use of bisphosphonates in the treatment of Paget’s disease of bone, the efficacy of different bisphosphonates in controlling disease activity, and the possible rare side effects of bisphosphonates. Symptoms are the main indication for treatment in Paget’s disease of bone. As treatment benefits in asymptomatic individuals remain controversial and nonevidence based, the decision to treat these patients should be individualized to their risk and benefit profiles. There are several trials conducted to evaluate and compare the efficacy of different regimes of bisphosphonates for treating Paget’s disease of bone. Most trials used biochemical markers rather than clinical symptoms or outcomes as parameters for comparison. Zoledronate is an attractive option as it can achieve high rates of biochemical remission and sustain long duration of suppression by a single dose. Atypical femoral fracture and osteonecrosis of the jaw are two rare and severe side effects reported, possibly related to the use of bisphosphonates in patients with osteoporosis and malignancy-induced hypercalcemia. As the regimes of bisphosphonates used for treating Paget’s disease of bone are different from those two diseases, the risks of developing these two possible side effects are expected to be very low, although this remains unknown. Vitamin D and calcium supplement should be given to patients at risk of vitamin D insufficiency when given zoledronate, as symptomatic hypocalcemia may develop. For those intolerant of bisphosphonates, subcutaneous calcitonin can be used for a limited period due to its associated risk of malignancy.

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“…Paget's disease is local rather than systemic. Even within the skeleton, single (monostotic) lesions are more commonly found on radiography than are polyostotic lesions 1–3,7 . Three phases of bone involvement have been identified, and although they follow a sequence, the phases generally overlap.…”

Section: Pathophysiologymentioning

confidence: 99%