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Suggest Medical Tests To Rule Out Paget's Disease
Question: Hi
I am a woman aged 40. All my life I have had joint pain. I have been tested many times for different things such as Rhuematoid arthritis etc. I have previously been diagnosed with fibromyalgia, 2 prolapsed discs to the lumbar part of my spine and other issues. I have now had a recent Nuclear CT bone scan which showed sclerosis to my neck - a large part. I have difficulty swallowing and have had this for over two years. I also have been diagnosed with a mass in my sinuses. That's why I was sent for the nuclear bone scan as the previous scan showed something in my neck. I have been cleared of Metatasis and bone cancer - all of my bloods are normal apart from usually raised CRP. I have now just had an MRI scan of my neck. They are thinking Pagets disease. What do you think?
I am a woman aged 40. All my life I have had joint pain. I have been tested many times for different things such as Rhuematoid arthritis etc. I have previously been diagnosed with fibromyalgia, 2 prolapsed discs to the lumbar part of my spine and other issues. I have now had a recent Nuclear CT bone scan which showed sclerosis to my neck - a large part. I have difficulty swallowing and have had this for over two years. I also have been diagnosed with a mass in my sinuses. That's why I was sent for the nuclear bone scan as the previous scan showed something in my neck. I have been cleared of Metatasis and bone cancer - all of my bloods are normal apart from usually raised CRP. I have now just had an MRI scan of my neck. They are thinking Pagets disease. What do you think?
Brief Answer:
paget's disease is quite likely..
Detailed Answer:
Hello Klt XXXXXXX Welcome to HCM..
I've gone through your detailed history, and really appreciate the detailed description of both past and present..excellent written history..
Really sorry to know all that you've been through already at such a young age..
Good to know that cancer/primary along with metastasis part is cleared(due to the unusual location of the mass)..
You should note that nuclear bone scans along with MRI is almost conclusive of paget's disease.. however some blood panel i.e Serum calcium, phosphate, parathyroid hormones and ALP shows variable features in Paget's disease depending on the stage of the disease as well as age of the affected person(40 yr is the exact cut off margin in this case, which is also another contributory factor for them to suspect this)..
Early diagnosis is a must in this case, because treatment is for long term and changes along with the course of the disease, which is why from all these extensive work-ups, i believe your in right hand..have faith, you'll get better..
Well CRP is actually the marker of inflammation, and from all these descriptions, it's quite apparent that there's a lot of different sources for inflammation, so that explains the persistent rise in CRP level(it's not really a specific marker, so not very conclusive in a multifactorial origin of ailment also)
I've given you a brief description of all these after analyzing your history, investigation & treatment summary..
Hopefully my advice will clear your doubt in this regard, fell free to ask further if your having any more queries, it'll be my pleasure to clarify..
Take Care
Kind Regards
paget's disease is quite likely..
Detailed Answer:
Hello Klt XXXXXXX Welcome to HCM..
I've gone through your detailed history, and really appreciate the detailed description of both past and present..excellent written history..
Really sorry to know all that you've been through already at such a young age..
Good to know that cancer/primary along with metastasis part is cleared(due to the unusual location of the mass)..
You should note that nuclear bone scans along with MRI is almost conclusive of paget's disease.. however some blood panel i.e Serum calcium, phosphate, parathyroid hormones and ALP shows variable features in Paget's disease depending on the stage of the disease as well as age of the affected person(40 yr is the exact cut off margin in this case, which is also another contributory factor for them to suspect this)..
Early diagnosis is a must in this case, because treatment is for long term and changes along with the course of the disease, which is why from all these extensive work-ups, i believe your in right hand..have faith, you'll get better..
Well CRP is actually the marker of inflammation, and from all these descriptions, it's quite apparent that there's a lot of different sources for inflammation, so that explains the persistent rise in CRP level(it's not really a specific marker, so not very conclusive in a multifactorial origin of ailment also)
I've given you a brief description of all these after analyzing your history, investigation & treatment summary..
Hopefully my advice will clear your doubt in this regard, fell free to ask further if your having any more queries, it'll be my pleasure to clarify..
Take Care
Kind Regards
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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