Two Rare Cases of Monostotic Paget’s Disease of Bone in Adult Female Volume 3 - Issue 4

Manohar TH*, Giriraj Harshavardhan JK and Gopinath Menon P

• Department of Orthopaedic Surgery, Sri Ramachandra Institute of Higher Education and Research, India

Received: February 14, 2020;   Published: March 03, 2020

Corresponding author: Manohar TH, Department of OrthopaedicsSurgery, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai -600116, Tamil Nadu, India

DOI: 10.32474/OSMOAJ.2020.03.000170

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Abstract

Introduction: Paget’s disease of bone is a metabolic bone condition characterized by increased bone resorption by osteoclasts with simultaneous new bone formation. The result of which is bone appears expanded with both lytic and sclerotic areas. The bone eventually becomes weak and starts producing symptoms such as pain, difficulty in walking if it involves the weight bearing bones, pathological fracture and systemic symptoms related to increased bone turnover.

Case presentation: Here we are reporting two adult female cases of monostotic Paget’s disease involving tibia. A 58-year-old female and a 47 year old female who presented with complaints of pain in the leg with history of fever. Blood investigations showed elevated alkaline phosphatase with normal serum calcium and phosphorous. X ray of tibia showed lytic and sclerotic areas. MRI showed features of Paget’s disease of tibia. Biopsy of tibia confirmed the diagnosis to be monostotic Paget’s disease of tibia. They were managed conservatively with oral bisphosphonates.

Conclusion: Monostotic Paget’s disease even though is a rare disease it is encountered now and then in Indian population. It has to be differentiated from other lesions producing similar clinical picture such as secondary osteosarcoma, sclerosing osteomyelitis and metastasis. Early diagnosis and appropriate treatment will reduce pain, deformity and the need for surgical intervention with good symptomatic and radiological recovery.

Keywords: Paget’s Disease; Monostotic Type; Tibia; Rare Condition; Indian Population

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