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Paget’s Disease Of The Bone

Reasons to choose Wilson Browne

11th January 2023 is International Paget’s Disease Awareness Day. This is a disease that most people have not heard of, despite the UK having the highest prevalence of Paget’s Disease in the world.

Paget’s Disease of the Bone (or “Paget’s Disease”) is named after Sir James Paget, who first identified the condition in the 19th century and had his first paper published on the subject in 1877. The awareness day on 11th January 2020 will mark the 206th anniversary of the birth of Sir James Paget.

Paget’s Disease is a condition which disrupts the normal cycle of bone renewal. Bones are a living, active tissue that are constantly renewed and repaired. Bone cells regenerate in a similar way to skin – old bone is removed and is replaced by new bone. There are two cells that are responsible for this: osteoclasts (cells that absorb old bone) and osteoblasts (cells that make new bone).

In sufferers of Paget’s Disease, something goes wrong with the osteoclast cells and they start to absorb bone at a much faster rate than usual. The osteoblast cells then try to produce bone more quickly, but the new bone is larger and weaker than normal – it can even be abnormal in shape. The rate of bone turnover can increase by up to 40 times in those affected.

Paget’s Disease is most common in the UK. It is rare in people under 50, but becomes increasingly common with age. It has been estimated that around 2-3 people in 100 over the age of 50 in the UK have Paget’s Disease in some part of their skeleton. However, it may not necessarily cause any symptoms and often goes unnoticed.

Paget’s Disease can be diagnosed by a simple blood test (as often those with Paget’s disease have raised levels of alkaline phosphatase in their blood), but an X-ray or scan is needed to confirm the diagnosis as it is not always the case that those levels are raised, or even if they are it may be caused by another condition.

However, it is estimated that as few as 7% of those who have X-ray evidence of Paget’s Disease actually receive medical attention for the disease. Only a relatively small number of cases are satisfactorily diagnosed and referred to a specialist, because of the lack of awareness surrounding the disease.

Paget’s disease typically affects the pelvis, spine, skull, shoulders or legs. The symptoms can include: constant, dull bone pain; joint pain, stiffness and swelling; a shooting pain, numbness and tingling, or loss of movement in part of the body. Unfortunately in many cases there are no symptoms, and the condition is only found during tests carried out for another reason.

The symptoms of Paget’s disease are easily managed with medication, but where it is left untreated it can lead to complications such as fragile bones that break more easily; enlarged or misshapen bones; permanent hearing loss (if skull is affected); too much calcium in the blood; heart problems; or in rare cases, bone cancer. These complications are irreversible.

As Paget’s Disease can cause irreversible damage if it is left untreated, it is vital that medical professionals diagnose and treat a patient in a prompt manner. If your Paget’s Disease was misdiagnosed or diagnosed later than it should have been, you may have a claim in clinical negligence.

Our specialist Medical Negligence team have experience in dealing with cases of Paget’s Disease, as shown in the case study below which is for a type of Paget’s Disease. We can support you through the claim and enable you to achieve the justice that you deserve.

Case Study

We acted for a lady in connection with a delayed diagnosis of Paget’s Disease, which is a form of breast cancer.

The claim was investigated against the GP Practice and also Northampton General Hospital, as it was considered that a number of GPs who had seen her had delayed in not referring her to the hospital; and when she was referred to the hospital, the Consultant Breast Surgeon failed to carry out a punch biopsy. If these tests had been carried out then the diagnosis could have been made 5 or 6 months earlier.

Due to the delay in diagnosis the client had to undergo a left mastectomy, which we accepted would have been the treatment if a diagnosis had been made earlier but she would have avoided having to have chemotherapy and radiotherapy treatment and also having to take Herceptin and Tamoxifen.

The case progressed and proceedings were issued at court. We relied on evidence from a Consultant Breast and General Surgeon and also on a Oncologist. The claim against the General Practice was discontinued and the hospital admitted liability but initially denied causation. Shortly after exchange of expert evidence the Defendants made an offer of settlement which our client accepted.

The case settled for a five-figure sum.

Gemma White


Gemma White

Trainee Solicitor

Gemma is a Trainee Solicitor in the Private Client team at our Northampton office. She assists the team on a variety of matters including Wills, Lasting Powers of Attorney and Estates.