Paget's disease of the bone

Key Information

Appropriate Tests


Clinical assessment, with diagnostic imaging. Serum PINP or Bone-specific alkaline phosphatase reflect bone formation rate and are useful in both diagnosis and in monitoring. Total Alkaline phosphatase(isolated elevation, with normal GGT) is less sensitive but specific but may be adequate in poly-ostotic disease.

Alternatively, urine NTX (morning fasting spot urine) is equally useful as a marker of bone resorption in diagnosis and monitoring.

Bone biopsy sometimes helpful to exclude other lesions. Serial  measurement of serum procollagen type I N propeptide (PINP), Bone specific alkaline phosphatase (B-ALP) or urine N-terminal cross-linking telopeptide of type I collagen (NTX) to monitor response to treatment.

See also Paget's disease of the breast and Paget's disease extramammary.


Cundy T, Reid IR. Clin Biochem. 2012; 45:970-5.

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