Paget’s Disease of bone : Mnemonic


  1. Osteitis deformans
  2. Collage of matrix madness
Paget's disease bone
Jmarchn, CC BY-SA 4.0, via Wikimedia Commons

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

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