PAGET’S DISEASE OF THE BONE: AN UNUSUAL CAUSE OF LOW BACK PAIN IN AN ADULT MALE

Abstract

Paget’s disease of the bone (PDB) or osteitis deformans is a chronic metabolic bone disorder, characterized by focal increase in bone resorption, followed by a rapid and abnormal bone repair with a disorganized and excessive bone formation, leading to pain, bone deformities and, eventually, fractures. Although the exact etiology of the disease remains controversial, genetic background and environmental factors (viral infections) are typically involved in the complex pathobiology pathways of PDB. The diagnosis of PDB, subsequent classification in disease subtype (monostotic or polyostotic), activity and severity, and complications (fracture, deformities, osteoarthritis, secondary development of tumors, hearing loss, neural compression, high output congestive cardiac failure) are usually made using a sequence of a blood tests (biochemical markers of bone turnover, especially elevated serum alkaline phosphatase) and imaging (x-ray or bone scan). Bisphosphonates are widely used for the management aiming to reduce bone turnover, promote healing of osteolytic lesions and improve bone pain. We report the case of a polyostotic Paget’s disease of bone as an unusual case of low back pain.

Keywords

• low back pain
• paget bone disease
• zoledronic acid