A Case Report on Diagnosis and Management of Paget’s Disease

Abstract

Background: Paget’s disease (osteitis deformans) of bone is a localized skeletal disorder characterized by either mono or polyostotic manifestations. Paget's disease might be asymptomatic as with normal biomarkers or it can be symptomatic such as bony enlargement or deformity.  Case Presentation: A 47-year-old female patient was presented to our facility with an elevated alkaline phosphatase (ALP) level for 1 year. Upon reviewing the patient's test results were suggestive of increased ALP, it was determined that the elevated ALP level was likely of osseous origin. However, no bone deformities were observed in the patient. A bone scan was conducted, which indicated the presence of Paget's disease, characterized by increased blood flow, pooling and intense osteoblastic activity observed in the patient's left sided pelvic bones. The diagnosis of Paget's disease was confirmed through a technetium-99m methylene diphosphonate (Tc-99m MDP) bone scan. Inj. Zoledronic acid and oral calcium supplements were advised. Subsequently, after two months follow-up, her results showed normal alkaline phosphatase (ALP) level. Conclusion: Paget's disease, despite being classified as a skeletal disorder, may manifest without any noticeable symptoms or deformities. Its diagnosis is typically confirmed through laboratory analyses, specific findings observed in radiology or radionuclide scans and occasionally, through the confirmation of bone biopsy.