Paget’s Disease of bone : Mnemonic

Synonyms:

1. Osteitis deformans
2. Collage of matrix madness

Mnemonic: Sixteen “P”s

1. Paramyxovirus infection and inclusions in osteocalsts

2. Pain (most common symptom – localized fractures or nerve compressions)

3. Pelvis (most common site)

4. Polyostotic (more common; 85%)

5. Phases: Active (lytic, mixed, sclerotic) and Inactive

6. Plasma volume expansion due to AV shunting (high output cardiac failure)

7. Premalignant lesion (paget’s sarcoma in <1%)

8. Phosphorous and calcium normal

9. Phosphatase (ALP) elevated in blood (bone formation markers)

10. Proline (hydroxyproline), Peptides (N and C telopeptides), Pyridinoline (deoxypyridinoline) elevated in urine (bone resorption markers)

11. Pamidronate (bisPhosphonates) – 1st line drugs

12. PTH analogues (teriparatide) contraindicated (risk of secondary osteosarcoma)

13. Picture frame vertebra (pathognomic appearance in X-ray)

14. Pelvic brim sign (thickening of pelvic brim outlined by iliopectineal line)

15. Platybasia and basilar invagination

16. Pyre (candle flame or blade of grass) sign: lucent leading edge in a long bone seen during the lytic phase

Dr. Sulabh Kumar Shrestha, MS Orthopedics

He is the section editor of Orthopedics in Epomedicine. He searches for and share simpler ways to make complicated medical topics simple. He also loves writing poetry, listening and playing music.