Wysiński Piotr, Krajewska-Włodarczyk Magdalena
Department of Rheumatology, Municipal Hospital Complex, Olsztyn, Poland.
Department of Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland.
Reumatologia. 2019;57(3):167-172. doi: 10.5114/reum.2019.86428. Epub 2019 Jun 28.
Paget's disease of bone (PDB) is a localized, chronic bone metabolic disorder, characterized by an osteoclastic malfunction, causing increased bone resorption and subsequent compensatory creation of new bone with a defective microstructure. Monostotic cases of PDB are less common than asymmetrical polyostotic PDB cases. The radiological diagnosis of PDB is usually straightforward, but monostotic cases can cause diagnostic difficulties. We report a case of monostotic PDB in a 64-year-old man. He experienced pain of the left lower extremity and radiological investigations revealed irregular areas of bone destruction in the left femur. Bone biopsy findings indicated PDB. Treatment with bisphosphonates was initiated, but after about three years of treatment left hip arthroplasty was required due to a large area of bone destruction. Presentation of this case report aims to discuss diagnostic challenges of monostotic cases of PDB and present guidelines of treatment.
骨佩吉特病（PDB）是一种局限性慢性骨代谢紊乱疾病，其特征为破骨细胞功能异常，导致骨吸收增加，随后代偿性形成微观结构有缺陷的新骨。单发性PDB病例比不对称性多骨性PDB病例少见。PDB的放射学诊断通常较为直接，但单发性病例可能会造成诊断困难。我们报告一例64岁男性的单发性PDB病例。他出现左下肢疼痛，放射学检查显示左股骨有不规则骨破坏区域。骨活检结果表明为PDB。开始使用双膦酸盐进行治疗，但治疗约三年后，由于大面积骨破坏，需要进行左髋关节置换术。本病例报告的目的是讨论单发性PDB病例的诊断挑战并提出治疗指南。
