Complications of Pagets Disease of Bone
What complications can arise in Pagets Disease of Bone?
- Skeletal
- Bone pain
- Bone and joint deformities (bowing, frontal bossing)
- Fractures (7% of patients)
- Neurologic
- Deafness (auditory nerve entrapment or involvement of bones of inner ear; 13%)
- Nerve entrapment (cranial nerves, spinal nerve roots)
- Spinal stenosis
- Basilar invagination
- Headaches, vertigo, tinnitus
- Stroke (blood vessel compression)
- Vascular
- Hyperthermia
- Vascular steal syndrome (external carotid blood flow to the skull at the expense of the brain)
- Cardiac
- High-output congestive heart failure (due to increased pagetic bone vascularity when over 40% of skeleton involved)
- Hypertension
- Cardiomegaly
- Angina
- Malignancy
- Osteogenic sarcomas (most commonly in humerus; 1%)
- Fibrosarcomas, chondrosarcomas
- Benign giant cell tumors
- Metabolic
- Hypercalcemia
- Hypercalcuria
- Nephrocalcinosis