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How is Paget disease of bone related to an increased risk of fractures and arthritis?

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bone disease Defect of tibia, caused by septic osteomyelitis in childhood, with compensatory thickening of the fibula (right). Normal bones are shown at left.

Paget disease of bone is a chronic condition characterized by a chaotic cycle of excessive bone breakdown and disorganized bone formation. This process leads to significant structural changes that increase the risk of fractures and arthritis.12

Impact on Bone Integrity and Fractures

The disease involves highly active osteoclasts that rapidly resorb bone, followed by osteoblasts that create new, but structurally unsound, bone tissue. During the bone-constructive stages, the resulting bone becomes dense yet brittle, making it highly susceptible to pathological fractures. These fractures occur because the bone lacks the normal, organized architecture required to withstand mechanical stress.12

Relation to Arthritis

Arthritis is a common complication of Paget disease, primarily due to the resulting bone deformities. As bones like the femur, pelvis, and spine become enlarged or bowed, they alter the alignment and weight distribution of the joints. This abnormal mechanical stress on the joints leads to the development of arthritis, causing pain and further limiting mobility.12