Osteoclastic dysfunction results in excess bone resorption and dysregulated bone remodelling which results in the formation of weakened, abnormal areas of bone.
Clinical Features
Patients are usually > 50 years
Bone pain is the most common complaint - most commonly the pelvis, skull and spine
Fractures of the weakened affected bone
Rarely, hearing loss - due to narrowing of the auditory foramen
On examination - frontal bossing
Investigations
Isolated raised ALP (rarely calcium may be raised in severe immobility)
Calcium, phosphate, PTH are normal
Management
1st Line - Bisphosphonates (IV zoledronate is preferred due to its efficacy and prolonged duration of action).
