Complications
Metabolic changes are increased at the early stages of pharmacological treatment and thus symptoms, particularly pain, may be increased during the first week of therapy.
An increase in the dose of analgesics may be required to control pain.
Limping is a common presenting symptom associated with arthritis, secondary to mechanical changes around joints (predominantly the hip).[3]
Joint arthroplasty may be required in patients with end-stage symptomatic arthritis.
Common in skull involvement (cranial nerve VIII).
Accompanied by facial pain due to involvement of the petrous temporal bone.
Hearing loss varies in degree, but it is not reversible.
Diagnosed with audiometry and treated with the use of hearing aids.
Spinal stenosis is common in patients with PDB due to narrowing of the spinal canal or due to the blood-supply-steal mechanism.[3]
May present with paraesthesias and muscle weakness.[23][24]
Radiological imaging is required to establish the mechanism.
Laminectomy is recommended; however, symptoms may not subside entirely.
Rarely, PDB is associated with the development of osteosarcoma.[3]
When there is a sudden onset or worsening of chronic pain, sarcoma should be considered.
Increased local pain accompanied by elevated erythrocyte sedimentation rate (ESR) may be a sign of osteosarcoma.
May occur due to high blood flow to highly metabolically active bone sites; however, is considered extremely rare.[3]
As a result of weakened affected bones.[3]
Commonly involves the femoral/hip bone or tibia.
May require open reduction and internal fixation.
Bisphosphonate use is contraindicated in people who have an existing swallowing impairment and significant gastro-oesophageal reflux disease or oesophageal motility disorders, because bisphosphonates are associated with erosive oesophagitis.
Patient should be switched to a parenteral bisphosphonate.
A common complication of any surgical treatment, especially if excessive bleeding has occurred.
Rare complication of PDB.[3]
May have various causes.
May require treatment with a shunt to provide cerebrospinal fluid diversion.
Due to bone metabolic imbalance.
Radiological imaging and urinalysis is required for diagnosis.
Increased intake of fluids is mandatory and pain management should be initiated.
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