PAGET’S Dz = OSTEITIS DEFORMANS

1-3% OF THE ELDERLY (3% > 40)

85% POLYOSTOTIC, 15% MONOSTOTIC

PRIMARILY ASYMPTOMATIC—-BONE PAIN, ENLARGING SKULL (PARIETAL BONES)–CHANGING HAT SIZE, HA’S, KYPHOSIS,

TYPICAL “COTTON WOOL” APPEARANCE ON X-RAY

GENU VARUS (BOWING LEGS),

CAN GET CONG HEART FAILURE FROM BONEY A-V FISTULAE

T- BONE INVOLVEMENT—CHL +/- SNHL–TINNITUS–VERTIGO

CHL PRIMARILY LOW F, SNHL HIGH F

PAGETOID BONE LAID DOWN ACROSS THE ANNULAR LIG (NO OSSICULAR FIXATION)

LYTIC STAGE—HIGH ALK PHOS AND ACID PHOS (OSTEOCLASTS), URINE HYDROXYPROLINE

MIXED STAGE (COMPENSATORY OSTEOBLASTIC REPAIR)

SCLEROTIC PHASE

OFTEN GET HYPER CA++

Rx : SALMON DERIVED TCT (CALCITONIN)—DISODIUM ETIDRONATE FOR INTRACTABLE BONE PAIN—-MITHRAMYCIN FOR RESISTANT CASES

NOT GOOD CANDIDATES FOR STAPEDECTOMY—DOES NOT SEEM TO WORK WELL

TREAT CHL WITH A HEARING AID