1. Paget's disease of bone Known as osteitisdeformans A chronic disorder that typically results in enlarged and deformed bones Paget's disease can cause bone to weaken, Bone pain The excessive breakdown and formation of bone tissue arthrites deformities,

2. cause Virus infections Canine distemper virus Respiratory syncytial virus Paramyxovirus

7. Symptoms Bone pain is the most common symptom Headaches and hearing loss may occur when Paget's disease affects the skull Pressure on nerves may occur when Paget's disease affects the skull or spine. Drowsiness

8. Symptoms Increased head size Curvature of spine may occur in advanced cases Hip pain may occur when Paget's disease affects the pelvic or thigh bone Damage to joint cartilage may lead to arthrities Teeth may spread intraorally Chalkstik #: Chalkstick fractures are fractures, typically of long bones, in which the fracture is transverse to the long axis of the bone, like a broken stick of chalk.

9. Diagnosis

10. Diagnosis

11. Skull radiograph cotton wool" appearance of the cranial vault

12. Radiograph of left femur Bone with cortical thickening

14. Surgery

16. Bisphosphonates Skelid (tiludronate disodium) -- Tablet; 400 mg (two 200 mg tablets) once daily for 3; Actonel (risedronate sodium) -- Tablet; 30 mg once daily for 2 months;

17. Calcitonin Miacalcin is administered by injection; 50 to 100 units daily or 3 times per week for 6-18 months

19. Diet and Exercise Patients with Paget's disease should receive 1000-1500 mg of calcium Adequate sunshine At least 400 units of vitamin D daily This is especially important in patients being treated with bisphosphonates.

20. Exercise Avoiding weight gain Maintaining joint mobility Flexibility exercises, such as stretching, improve the range of motion of muscles and joints Undue stress on affected bones should be avoided Relieve of pain

21. SHOULDER EXERCISE The shoulder shrug is another technique that may improve posture and reduce back pain Begin by standing erect with dumbbells or water bottles held at the sides of the body Lift the shoulders toward the head by elevating the shoulder girdle, and slightly retract the scapulae to rotate the shoulders back

22. SHOULDER EXERCISE Pause, and then return to the starting position. Avoid rocking or using the legs to initiate the exercise by slightly bending your knee Repeat the exercise three to five times

23. KNEE EXCERCISE A good starting point is the squat which targets the gluteals, hamstrings, and quadriceps Start by standing erect with a neutral spine and feet shoulder-width apart Slowly lower the body, with the hips moving back as if sitting in a chair.

25. Lower to approximately 90 degrees of knee flexion.

26. Pause, and then slowly return to the starting position

28. KNEE EXCERCISE The heel raise is another good exercise that targets the gastrocnemius and soleus Plantarflex up (stand on the toes) pause, then slowly lower to the starting position. Lastly the knee to chest technique is a great maneuver to help stretch the lower extremity and prevent cramping

29. KNEE EXCERCISE Lie on your back and pull one knee to your chest. Perform 1-2 sets of 3-5 repetitions per side Each repetition should last 15-30 seconds