The list of medical tests mentioned in various sources as used in the diagnosis of Paget's disease of bone includes:
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X-rays taken before overt symptoms develop show increased bone expansion and density. A bone scan, which is more sensitive than X-rays, clearly shows early pagetic lesions (radioisotope collects around areas of active disease). Computed tomography scan or magnetic resonance imaging shows extra bony extension if sarcomatous degeneration occurs. Bone biopsy reveals characteristic mosaic pattern.
Other laboratory findings include:
❑ elevated serum alkaline phosphatase levels (an index of osteoblastic activity and bone formation)
❑ elevated serum calcium.
Increasing use of routine chemistry screens (including serum alkaline phosphatase) is making early diagnosis more common. Serum osteocalcin and N-telopeptide are usually increased.
Source: Professional Guide to Diseases (Eighth Edition), 2005
X-rays taken before overt symptoms develop show increased bone expansion and density. A bone scan, which is more sensitive than an X-ray, clearly shows early pagetic lesions (radioisotope concentrate in areas of active disease). Bone biopsy reveals characteristic mosaic pattern. Other laboratory findings include:
❑ increased serum alkaline phosphatase (ALP) levels (an index of osteoblastic activity and bone formation)
❑ increased levels for markers of bone breakdown such as N-telopeptide
❑ increased 24-hour urine levels for hydroxyproline (amino acid excreted by the kidneys and an indicator of osteoclastic hyperactivity)
❑ increased or decreased serum calcium and ALP isoenzyme levels.
Source: Handbook of Diseases, 2003
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