How to determine if the pain is due to pagetic bone pain or Osteoarthritis

How to determine if the pain is due to pagetic bone pain or Osteoarthritis?

Pagets Disease of Bone and Osteoarthritis pain may both be described as “aching” and it is frequently difficult to distinguish which is causing symptoms in PDB patients.

PDB pain is more likely to be present at rest. However, pain from both PDB and OA may worsen with weight bearing. Bisphosphonate treatment can be helpful in distinguishing the cause of pain as it will improve pagetic bone pain within 3 to 4 months, but not osteoarthritic pain. Alternatively, an injection of lidocaine into the affected joint (usually the hip) will transiently eliminate pain resulting from osteoarthritis but not PDB.

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