Paget's disease of bone : Paget disease is a localized disorder of bone remodeling that typically begins with excessive bone resorption followed by an increase in bone formation. This osteoclastic overactivity followed by compensatory osteoblastic activity leads to a structurally disorganized mosaic of bone (woven bone), which is mechanically weaker, larger, less compact, more vascular, and more susceptible to fracture than normal adult lamellar bone.Individuals with Paget's disease experience rapid isolated bone repair, which causes a variety of symptoms from softer bones to enlarged bone growth, typically involving one or more bones of the pelvis, low back (spine), hips, thighs, head (skull) and arms. Medical therapies have proven effective in reducing the frequency of pain, fractures and arthritis that may be caused by this condition. Medications that help reduce the pain associated with Paget's include acetaminophen and anti-inflammatory drugs such as ibuprofen and naproxen. In addition, bisphosphonates reduce the pain and help the body regulate the bone-building process to stimulate more normal bone growth. Alendronate , Etidronate, Risedronate to be taken orally.There are also injectable medications. Injectable medications that can be given for Paget's include Pamidronate which is injected in the vein once a month or once every few months. Zoledronic acid which is injected in the vein once a year. Calcitonin, a hormone that is injected under the skin several times a week.Surgery for arthritis caused from Paget's disease is effective in reducing pain and improving function.Medical treatment is not expected to correct some of the changes of the Paget's disease that have already occurred, such as hearing loss, deformity or osteoarthritis.


Osteoporosis : Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine. Bone is living tissue, which is constantly being absorbed and replaced. Osteoporosis occurs when the creation of new bone doesn't keep up with the removal of old bone. Symptoms Signs and symptoms include: • Back pain, caused by a fractured or collapsed vertebra • Loss of height over time • A stooped posture • A bone fracture that occurs much more easily than expected Treatments For both men and women, the most widely prescribed osteoporosis medications are bisphosphonates. Examples include: • Alendronate (Fosamax, Binosto) • Risedronate (Actonel, Atelvia) • Ibandronate (Boniva) • Zoledronic acid (Reclast, Zometa)


Hypercalcemia : Hypercalcemia is too much calcium in the blood. Calcium is important to many body functions, including: • Bone formation • Hormone release • Muscle contraction • Nerve and brain function Parathyroid hormone (PTH) and vitamin D help manage calcium balance in the body. PTH is made by the parathyroid glands -- four small glands located in the neck behind the thyroid gland. Vitamin D is obtained when the skin is exposed to sunlight, and from dietary sources such as: • Egg yolks • Fish • Fortified cereals • Fortified dairy products Primary hyperparathyroidism is the most common cause of hypercalcemia. It is due to excess PTH release by the parathyroid glands. This excess occurs due to an enlargement of one or more of the parathyroid glands, or a growth (usually not cancer) on one of the glands. Other medical conditions can also cause hypercalcemia: • Adrenal gland failure • An inherited condition that affects the body's ability to regulate calcium (familial hypocalciuric hypercalcemia) • Being bedbound (or not being able to move) for a long period of time • Calcium excess in the diet (called milk-alkali syndrome, usually due to at least 2,000 milligrams of calcium per day) • Hyperthyroidism • Kidney failure • Medications such as lithium and thiazide diuretics (water pills) • Some cancerous tumors (for example, lung cancers, breast cancer) • Vitamin D excess (hypervitaminosis D) from diet or inflammatory diseases Symptoms Abdominal symptoms: • Constipation • Nausea • Pain • Poor appetite • Vomiting Kidney symptoms: • Flank pain • Frequent thirst • Frequent urination Muscle symptoms: • Muscle twitches • Weakness Psychological symptoms: • Apathy • Dementia • Depression • Irritability • Memory loss Skeletal symptoms: • Bone pain • Bowing of the shoulders • Fractures due to disease (pathological fractures) • Loss of height • Spinal column curvature Treatment Severe hypercalcemia that causes symptoms and requires a hospital stay is treated with the following: • Calcitonin • Dialysis • Diuretic medication, such as furosemide • Drugs that stop bone breakdown and absorption by the body, such as pamidronate or etidronate (bisphosphonates) • Fluids through a vein (intravenous fluids) • Glucocorticoids (steroids)