Year: 2024
Type: article
Study design: Observational Study
Abstract: Paget's disease of bone (PDB) is characterised by increased and disorganised bone remodelling leading to various complications, such as bone deformity, deafness, secondary osteoarthritis, and pathological fracture. Pain is the most common presenting symptom of PDB, but it is unclear to what extent this is due to increased metabolic activity of the disease, complications, or unrelated causes. We conducted a cross-sectional study of 168 people with PDB attending secondary care referral centres in the UK. We documented the presence of musculoskeletal pain and sought to determine its underlying causes. Musculoskeletal pain was reported by 122/168 (72.6%) individuals. The most common cause was osteoarthritis of joints distant from an affected PDB site in 54 (44.3%), followed by metabolically active PDB in 18 (14.7%); bone deformity in 14 (11.4%); osteoarthritis of a joint neighbouring an affected site in 11 (9.0%), neuropathic pain in 10 (8.2%), and various other causes in the remainder. Pain was more common in women (p<0.019) and in older individuals (p<0.001). Circulating concentrations of macrophage colony-stimulating factor (M-CSF) were significantly higher in those with pain (p = 0.008), but there was no difference between groups of patients with and without pain in concentrations of interleukin-6 (IL-6) or biochemical markers of bone turnover. Pain is a common symptom in PDB but is most often due to osteoarthritis at an unaffected site. The study illustrates the importance of fully evaluating people with PDB to determine the underlying cause of pain so that management can be tailored appropriately.
Source: Calcified Tissue International
Authors: Kathryn Berg, Dervil Dockrell, Lesley Colvin, William D Fraser, Jonathan CY Tang, Terry Aspray, Elaine Dennison, Hrushikesh Divyateja, Nazim Ghouri, Esther Hanison, Richard Keen, Eugene McCloskey, Terence W O’Neill, Faizanur Rahman, Mashood Siddiqi, Stephen Tuck, Jane Turton, Stuart H Ralston
Institutions: Western General Hospital, Institute of Genetics and Cancer, University of Edinburgh, University of Dundee, Ninewells Hospital, University of East Anglia, Norwich Research Park, Norfolk and Norwich University Hospital, Norfolk and Norwich University Hospitals NHS Foundation Trust, NIHR Newcastle Biomedical Research Centre, Newcastle University, University of Southampton, Nottingham University Hospitals NHS Trust, Queen Elizabeth University Hospital, University of Glasgow, Royal National Orthopaedic Hospital, Royal National Orthopaedic Hospital NHS Trust, Northern General Hospital, University of Manchester, Manchester University NHS Foundation Trust, NIHR Manchester Biomedical Research Centre, Centre for Epidemiology Versus Arthritis, University Hospitals of Leicester NHS Trust, Aintree University Hospitals NHS Foundation Trust, Aintree University Hospital, James Cook University Hospital, University Hospital Llandough
Language: English
Topic: Bone Metabolism and Diseases
Subfield: Molecular Biology
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $3,790
OpenAlex ID: W4402976507