Dear Dr. Donohue: Please explain the difference between Paget’s disease and osteoporosis. How do the symptoms differ? How does the doctor diagnose which one you have? Do they look different on a bone-density test?
Dear Reader: Beyond the fact that both are bone diseases, the two share little in common.
Osteoporosis is bone thinning, a condition common to many women after menopause with the waning of estrogen production. The female hormone estrogen keeps calcium in bones and maintains their strength. Without it, bones become brittle and fragile. Backbones collapse, giving a woman a stooped posture. Fractures are common, especially hip fractures. Osteoporosis affects many bones.
With Paget’s bone disease, there is an imbalance in the daily process of bone breakdown and buildup. The breakdown process runs amok, and the rebuilding process is at a loss to catch up. When it does, it turns out an inferior product. Paget’s disease, for the most part, is confined to a limited section of one or two bones.
Most Paget’s patients have no idea they have it, since only a small swatch of bone is affected. In a minority of Paget patients, bone pain, deformities and breaks occur.
Paget’s disease is treated with medicines such as alendronate, etidronate and calcitonin. Osteoporosis, on the other hand, responds to estrogen supplementation.
The two diseases present entirely different pictures on X-rays and bone-density images.
Dear Dr. Donohue: My grandson was born with Wolff-Parkinson-White syndrome. Could you expand on prognosis, treatment, etc.? – Mrs. J. L.
Dear Mrs. J. L.: Your grandson’s heart has a redundant electric cable, which can transmit extra signals from the pacemaker in his upper heart to the contracting lowering heart chambers. That redundant connection leads to episodes of rapid heart beating.
Often, medicines can control such episodes. When they fail to do the job, a doctor can thread a plastic tube through a blood vessel into the patient’s heart. When it reaches the WPW cable, radio waves are turned on. They destroy the cable and stop the sudden heart speedups.
I can understand your concern, but try not to anticipate the worst. Your grandson’s doctors have the situation in hand.
Write to Paul Donohue, M.D., P.O. Box 5539, Riverton, NJ 08077-5539.
