Table 1.

Indications for treatment of Paget’s disease of bone

• Any symptom that is caused by metabolically active Paget’s disease (ie, bone pain)

• Involvement of pagetic sites at high risk for complications (even in absence of symptoms):

a) Weight-bearing bones

b) Skull and/or spine

c) Bone adjacent to major joints such as hip or knee

• Planned surgery at a metabolically active pagetic site

• Immobilization (leading to hypercalcemia)