Causes of Musculoskeletal Pain in Paget’s Disease of Bone

Paget's disease of bone (PDB) is characterised by increased and disorganised bone remodelling leading to various complications, such as bone deformity, deafness, secondary osteoarthritis, and pathological fracture. Pain is the most common presenting symptom of PDB, but it is unclear to what extent this is due to increased metabolic activity of the disease, complications, or unrelated causes. We conducted a cross-sectional study of 168 people with PDB attending secondary care referral centres in the UK. We documented the presence of musculoskeletal pain and sought to determine its underlying causes. Musculoskeletal pain was reported by 122/168 (72.6%) individuals. The most common cause was osteoarthritis of joints distant from an affected PDB site in 54 (44.3%), followed by metabolically active PDB in 18 (14.7%); bone deformity in 14 (11.4%); osteoarthritis of a joint neighbouring an affected site in 11 (9.0%), neuropathic pain in 10 (8.2%), and various other causes in the remainder. Pain was more common in women (p<0.019) and in older individuals (p<0.001). Circulating concentrations of macrophage colony-stimulating factor (M-CSF) were significantly higher in those with pain (p = 0.008), but there was no difference between groups of patients with and without pain in concentrations of interleukin-6 (IL-6) or biochemical markers of bone turnover. Pain is a common symptom in PDB but is most often due to osteoarthritis at an unaffected site. The study illustrates the importance of fully evaluating people with PDB to determine the underlying cause of pain so that management can be tailored appropriately.

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Publication Details

Journal
Calcified Tissue International
Published
2024-09-30
DOI
https://doi.org/10.1007/s00223-024-01279-0
Citations
4
Primary Topic
Bone health and treatments
Type
article
Field-Weighted Citation Impact
1.13

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article

Causes of Musculoskeletal Pain in Paget’s Disease of Bone

Terence W O’Neill, Jonathan Tang, Terry Aspray, William D. Fraser et al.
4 citations
Calcified Tissue International
Bone health and treatments
1.13
article

Causes of Musculoskeletal Pain in Paget’s Disease of Bone

Terence W O’Neill, Jonathan Tang, Terry Aspray, William D. Fraser, Hrushikesh Divyateja, Dervil Dockrell, Lesley Colvin, E Hanison, Stuart H. Ralston, Kathryn Berg, Nazim Ghouri, Richard Keen, Jane F. Turton, Elaine Dennison, Stephen Tuck, Eugene McCloskey, Mashood Siddiqi, Faizanur Rahman
article en
4 citations

Abstract

Paget's disease of bone (PDB) is characterised by increased and disorganised bone remodelling leading to various complications, such as bone deformity, deafness, secondary osteoarthritis, and pathological fracture. Pain is the most common presenting symptom of PDB, but it is unclear to what extent this is due to increased metabolic activity of the disease, complications, or unrelated causes. We conducted a cross-sectional study of 168 people with PDB attending secondary care referral centres in the UK. We documented the presence of musculoskeletal pain and sought to determine its underlying causes. Musculoskeletal pain was reported by 122/168 (72.6%) individuals. The most common cause was osteoarthritis of joints distant from an affected PDB site in 54 (44.3%), followed by metabolically active PDB in 18 (14.7%); bone deformity in 14 (11.4%); osteoarthritis of a joint neighbouring an affected site in 11 (9.0%), neuropathic pain in 10 (8.2%), and various other causes in the remainder. Pain was more common in women (p<0.019) and in older individuals (p<0.001). Circulating concentrations of macrophage colony-stimulating factor (M-CSF) were significantly higher in those with pain (p = 0.008), but there was no difference between groups of patients with and without pain in concentrations of interleukin-6 (IL-6) or biochemical markers of bone turnover. Pain is a common symptom in PDB but is most often due to osteoarthritis at an unaffected site. The study illustrates the importance of fully evaluating people with PDB to determine the underlying cause of pain so that management can be tailored appropriately.

Calcified Tissue InternationalVol. 115(5)
University of East Anglia (GB), Nottingham University Hospitals NHS Trust (GB), University of Nottingham (GB), University of Liverpool (GB), University of Dundee (GB), Aintree University Hospitals NHS Foundation Trust (GB), Norfolk and Norwich University Hospital (GB), Western General Hospital (GB), Norfolk and Norwich University Hospitals NHS Foundation Trust (GB), James Cook University Hospital (GB), Northern General Hospital (GB), University Hospitals of Leicester NHS Trust (GB), Ninewells Hospital (GB), Edinburgh Cancer Research (GB), Royal National Orthopaedic Hospital (GB), Nottingham City Hospital (GB), Manchester University NHS Foundation Trust (GB), Arthritis UK (GB), NIHR Newcastle Biomedical Research Centre (GB), University Hospital Llandough (GB), MRC Lifecourse Epidemiology Unit (GB), Genomics (United Kingdom) (GB), Queen Elizabeth University Hospital (GB), NIHR Manchester Biomedical Research Centre (GB), University of Southampton (GB), University College London (GB), University of Glasgow (GB)
Medical Research Council, Engineering and Physical Sciences Research Council, Biotechnology and Biological Sciences Research Council, H2020 European Research Council
Good health and well-being
Openalex Percentile: Top 18%
Bone health and treatments
1.13
DOIOpen Access PDFOpenAlex
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