Paget's disease: the symptoms

One of the most "traditional" symptoms is the "hat sign". It represents the need to change hat because of the hypertrophy of the cranial vault. This sign goes back to the time when the disease was discovered, and where men wore hats ...

The symptoms are rare in Paget's disease. But sometimes pains, fractures, osteo-articular deformities, or even symptoms of nerve compression (deafness, paralysis, etc.) reveal Paget's disease.

Most often, Paget's disease is accidentally discovered during a radiological assessment. Signs more or less characteristic of the disease are then visible on imaging, the most obvious pus being the hypertrophy and heterogeneity of the bone tissue reached.

It is also possible to notice vertebrae in frame or "ivory", vertebral settlements, incurvations of long saber-shaped bones, cracks of long bones in chalk or even fractures.

Thickening of the skull vault may exist as well as deformation of the base of the skull.

Paget's disease is a benign disease that progresses locally and slowly only on bones that are already affected.

Complementary examinations are often prescribed:

A skeleton scan of the entire skeleton is prescribed to visualize bone foci invisible on the radio. It will serve as a basis for monitoring the disease. The affected bone areas will be hyperfixing.

A blood test is required mainly for the determination of alkaline phosphatase; it is a good marker of bone remodeling. Markers of bone resorption are also required, they are increased in Paget's disease proportionally to bone involvement; these can be normal when the bone lesions are minimal.

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