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How is Paget's disease diagnosed?

Your doctor may be able to diagnose Paget’s from your symptoms and a physical examination if your bone is deformed in a way that’s typical of the condition, but often you’ll need x-rays and blood tests to confirm it. Some blood tests will point to Paget’s disease even if you don’t have any obvious symptoms.

A blood test may show you have a raised level of an enzyme called alkaline phosphatase. There are many reasons why you might have this blood test, and many conditions besides Paget’s disease can cause the level of alkaline phosphatase to rise, so you’ll need further tests before a definite diagnosis of Paget’s disease can be made.

Sometimes the doctor will ask for an isotope bone scan, which is the most effective way of pinpointing where your affected bone is, how much bone is affected and how active it is. A tiny, well-tolerated dose of radioactive isotope, which can be detected by the bone scan, is injected into your vein and your whole skeleton is scanned several hours later. The amount of radioactivity injected is far too small to cause any harm to the body. The isotope is concentrated in the areas of bone affected by Paget’s disease so that they show up clearly when the body is scanned with a special camera. After the scan, the radioactive material quickly passes out of your body in your urine.

Once the diagnosis has been made, you may be referred to a specialist clinic for assessment and treatment.

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