Guidelines for diagnosis and management of Paget's disease of bone in Japan
| Autor: | Shinjiro Takata, Masaaki Zamma, Kousei Yoh, Ikko Ohno, Stuart H. Ralston, Hirotoshi Morii, Jun Hashimoto, Satoshi Abe, Noriko Yoshimura, Hideki Yoshikawa, Masao Fukunaga, Hiroo Yabe, Masaki Terada, Kiyoshi Nakatsuka |
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| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism information science Physical examination macromolecular substances environment and public health Bone resorption Bone remodeling Endocrinology Japan Internal medicine medicine Humans natural sciences Orthopedics and Sports Medicine Medical history Radionuclide Imaging medicine.diagnostic_test business.industry General Medicine Osteitis Deformans medicine.disease Surgery Radiography Paget's disease of bone Bone scintigraphy health occupations Osteosarcoma business Rare disease |
| Zdroj: | Journal of Bone and Mineral Metabolism. 24:359-367 |
| ISSN: | 1435-5604 0914-8779 |
| DOI: | 10.1007/s00774-006-0696-x |
| Popis: | We here propose guidelines for the diagnosis and management of Paget's disease of bone (PDB) in Japan. These guidelines provide basic information on the epidemiology, pathophysiology, clinical signs and symptoms, diagnosis, indications for treatment, and available therapy, including orthopedic surgery. PDB is a chronic disorder characterized by focal abnormalities of bone turnover. The characteristic feature of PDB is excessive osteoclastic bone resorption coupled to increased and disorganized bone formation. The most common symptom of PDB is pain in involved bones. The most serious complication of PDB is malignant bone or soft-tissue tumor. PDB is uncommon in Japan; our survey in 2003 found 169 patients with PDB. The prevalence of PDB in Japan is 0.15/100 000; in patients aged 55 years or more, the proportion reaches 0.41/100 000. A careful medical history and physical examination are essential for the diagnosis. The diagnosis of PDB is based on finding the typical features on radiographs. Bone scintigraphy and measurement of serum alkaline phosphatase are sensitive means of screening for PDB. Since PDB is a rare disease in Japan, bone biopsy is quite often used to exclude bone metastases. The only evidence-based indication for treatment of PDB is pain in involved bones. In Japan, etidronate and calcitonin are approved by the Ministry of Health, Labour and Welfare for treating PDB, but currently risedronate is also under development for treating PDB in Japan. Indications for surgical intervention in PDB include unstable fractures, osteoarthritis, malignant soft-tissue tumor, osteosarcoma, and bone deformity. |
| Databáze: | OpenAIRE |
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