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Previous Volume 355:593-600 August 10, 2006 Number 6 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A 69-year-old man reports increasing pain in the right leg. Physical examination reveals warmth and anterolateral bowing of the right shin. The serum alkaline phosphatase level is 260 U per liter (normal, 38 to 126 U per liter). A skeletal scintigraphic scan reveals enhanced uptake in only the deformed tibia, where a radiograph shows changes indicative of Paget's disease. His sister, whose . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Evaluation

Supportive Therapy

Pharmacologic Therapy

            Bisphosphonates

            Salmon Calcitonin

Assessing Pharmacologic Treatment

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Division of Bone and Mineral Diseases, Washington University School of Medicine at Barnes–Jewish Hospital, and the Center for Metabolic Bone Disease and Molecular Research, Shriners Hospitals for Children — both in St. Louis.

Address reprint requests to Dr. Whyte at Shriners Hospitals for Children, 2001 S. Lindbergh Blvd., St. Louis, MO 63131, or at mwhyte@shrinenet.org.

This article has been cited by other articles:

• Mastaglio, C., Arnoldi, C., Corbellini, E., Severi, C., Fantini, F. (2008). Characterization of Osteocortical-Periosteal Layers by High-Resolution Sonography Using a Doppler Technique in Paget's Disease of Bone. Journal of Diagnostic Medical Sonography 24: 136-144 [Abstract]  
• Kimmel, D.B. (2007). Mechanism of Action, Pharmacokinetic and Pharmacodynamic Profile, and Clinical Applications of Nitrogen-containing Bisphosphonates. JDR 86: 1022-1033 [Abstract] [Full Text]  
• CHAFFINS, J. A. (2007). Paget Disease of Bone. radtech 79: 27-40 [Abstract] [Full Text]