The rheumatology of Paget's disease.

Up to 60% of patients with symptomatic Paget's disease develop articular symptoms in its course. Effective therapy may depend on accurate localization of all symptoms and many patients will have an overlap of bone and articular symptoms which may prove impossible to separate. Over the past 10 years there have been major advances in drug therapy for Paget's disease but still the ideal agent is not currently available. Analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) remain the basis of treatment for arthritis and there is no evidence yet that calcitonin or the diphosphonates will inhibit its development. Orthopaedic procedures, especially osteotomy for deformity and joint replacement may be indicated in selected cases.