Here are some less common diseases and disorders that can affect the bones and joints:
• Paget's disease. Also called osteitis deformans, this chronic disorder disturbs the normal process of bone formation. The disease is more common among men and among adults age 40 and older. The cause of the disease is unknown. With Paget's disease, normal bone breaks down more rapidly than usual and is replaced by abnormal bone. The new, abnormal bone is larger but weaker than healthy bone. Paget's disease usually affects the leg bones, upper arm bone, collarbone, and pelvis. Bone pain, deformity, and fractures are the most common symptoms. A diagnosis of Paget's disease is confirmed with X rays and blood tests. Most cases do not require treatment other than painkillers such as aspirin and regular monitoring of the affected bones. In severe cases, treatment may include calcitonin or etidronate to relieve pain and to promote natural bone formation. In some cases, surgery to correct the bone deformities may be necessary.
• Osteomalacia. This condition weakens the bones of adults through demoralization (excessive loss of calcium and phosphorus). Osteomalacia is caused
Joints by vitamin D deficiency, which usually results from insufficient vitamin D 319
intake, limited exposure to sunlight, or inadequate absorption of vitamin D by Bones and the intestines. Kidney disease, certain metabolic disorders, and some medications also can increase the risk of developing osteomalacia. Symptoms include bone pain, usually in the neck, ribs, hips, and legs; restricted mobility; and difficulty walking. Diagnosis is based on symptoms, X rays, and the results of blood tests. Treatment focuses on increasing vitamin D levels in the body. The doctor also may recommend calcium supplements. Any underlying cause of the disease also must be treated.
Ankylosing spondylitis. Ankylosing spondylitis is a form of arthritis that primarily affects the spine, shoulders, hips, and knees. Ankylosing spondylitis frequently begins between ages 20 and 40 and is more likely to occur in men than in women. It appears to run in families. Symptoms include pain and stiffness (in the lower back, especially after resting), chest pain, loss of appetite, and redness and pain in the eye (due to inflammation of the iris). As the disease progresses, it can be extremely painful and crippling. In severe cases, the vertebrae in the spine may fuse. Diagnosis is based on symptoms, blood tests, and X rays. There is no cure for ankylosing spondylitis. However, symptoms may be relieved with heat treatments, massage, and a supervised exercise program to strengthen the back muscles. The doctor also may prescribe non-steroidal anti-inflammatory drugs to reduce pain and stiffness.
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