GuidelinesEML (Adult Hospital STG)
Paget's Disease
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition
ICD-10 Code: M88.08/M88.80-99
DESCRIPTION
- Bone disease characterised by localised uncontrolled formation of highly active osteoclasts leading to an increase in bone resorption followed by chaotic increase in bone formation.
GENERAL MEASURES
- Most cases are mild and asymptomatic and no treatment is required.
- The diagnosis is supported by isolated high alkaline phosphatase and typical CXR radiological changes.
- Avoid high calcium diet when immobile as hypercalcaemia may occur with immobilisation.
- Differentiate bone pain of Paget’s, especially at night, from arthritic pain in joints near deformed bone, e.g. hip and knee joints, as well as pain resulting from fracture or complicating osteosarcoma.
MEDICINE TREATMENT
For arthritic pain:
- NSAID, e.g.:
- Ibuprofen, oral, 400 mg 8 hourly with meals.
REFERRAL
- All patients.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2024 Edition
Drugs mentioned
ICD-10 codes
- M88.08Paget's disease of skull, other site
- M88.80Paget's disease of other bones, multiple sites
- M88.81Paget's disease of other bones, shoulder region
- M88.82Paget's disease of other bones, upper arm
- M88.83Paget's disease of other bones, forearm
- M88.84Paget's disease of other bones, hand
- M88.85Paget's disease of other bones, pelvic region and thigh
- M88.86Paget's disease of other bones, lower leg
- M88.87Paget's disease of other bones, ankle and foot
- M88.88Paget's disease of other bones, other site
- M88.89Paget's disease of other bones, site unspecified
- M88.90Paget's disease of bone, unspecified, multiple sites
- M88.91Paget's disease of bone, unspecified, shoulder region
- M88.92Paget's disease of bone, unspecified, upper arm
- M88.93Paget's disease of bone, unspecified, forearm
- M88.94Paget's disease of bone, unspecified, hand
- M88.95Paget's disease of bone, unspecified, pelvic region and thigh
- M88.96Paget's disease of bone, unspecified, lower leg
- M88.97Paget's disease of bone, unspecified, ankle and foot
- M88.98Paget's disease of bone, unspecified, other site
- M88.99Paget's disease of bone, unspecified, site unspecified