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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2010, Number 1

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Acta Ortop Mex 2010; 24 (1)

Monostotic patellar paget’s disease

Hernández-Pascual C, Villanueva-Martínez M, Ríos-Luna A, Benito-del Carmen F, Castelorio R, Marañón MHGUG
Full text How to cite this article

Language: Spanish
References: 11
Page: 14-17
PDF size: 86.68 Kb.


Key words:

osteitis, pain, pathological fracture, wound and injuries, biofosfate, knee.

ABSTRACT

Paget’s disease or osteitis deformans is a bone metabolic disease characterized by an increased bone resorption followed by an increased but irregular bone formation. This results in a weakened, deformed bone and an increase bone mass with collagen fibers forming an irregular and pathologic mosaic instead of the parallel symmetry that characterizes healthy bone. It is considered as a non-neoplastic disorder that mimics a bone tumor. Its origin is still uncertain; however, it has been postulated that genetic or environmental factors are involved in its etiology. It rarely occurs in young patients and its prevalence increases with age. It usually affects both genders with a slight predominance of males. It may be symptomatic or asymptomatic depending on the bones involved, with the most common clinical manifestation being pain of the affected bone. Lesion distribution varies from monostotic involvement (25%) to generalized disease (75%). The most frequent complication is a fracture in a pathological area, while the most serious one is sarcomatous degeneration (~ 1%; higher in the generalized form). The diagnosis is usually radiologic, by means of plain X-rays and biochemical markers such as alkaline phosphatase, among others, which is elevated in 85% of patients. Treatment of this disease consists of bisphosphonates, which have a proven efficacy and high remission rates. They are indicated in patients with clinical manifestations and in asymptomatic patients with evidence of disease activity. We report the case of a patient with Paget’s disease in an infrequent location as is the patella.


REFERENCES

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  2. Carnesale PG: Tumores de los tejidos blandos y trastornos no neoplásicos que simulan tumores óseos. Campbell, WC, editor. Cirugía Ortopédica. Vol. I. Cap. 23. Madrid: Elsevier España, SA, 2004: 859-81

  3. Roux C, Dougados M: Treatment of patients with Paget´s disease of bone. Drugs 1999; 58: 823-30.

  4. Joshua F, Epstein M, Major G: Biphosphonate resistance in Paget´s disease of bone. Arthritis Rheum 2003; 48: 2321-3.

  5. Morissette J, Laurin N, Brown JP: Sequestosome 1: Mutation frequencies, haplotypes and phenotypes in familial Paget´s disease of bone. J Bone Miner Res 2006; 21: 38-44.

  6. Morales-Piga AA, Rey-Rey JS, Corres-González J, et al: Frequency and characteristics of familiar aggregation of Paget´s disease of bone. J Bone Miner Res 1995; 10: 663-70.

  7. Reddi SV: Aetioloy´s of Paget disease and osteoclast abnormalities. J Cel Biochem 2004; 93: 688-96.

  8. Roodman GD, Windle JJ: Paget´s disease of bone. J Clin Invest 2005; 115: 200-8.

  9. Morris CD, Einhorn TA: Biphosphonates in orthopedic surgery. J Bone Joint Surg AM 2005; 87: 1609-18.

  10. Reszka AA, Rodan GA: Mechanism of action of biphosphonates. Curr Osteo Reports 2003; 1: 45-52.

  11. Meunier PG, Vignon E: Therapeutic strategy in Paget´s disease of bone. Bone 1999; 17 (5 suppl): 489s-491s.




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Acta Ortop Mex. 2010 Ene-Feb;24