skip to main content

Paget disease of bone — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

HardMetabolic Bone DiseasePaget disease of boneSCE Rheumatology

A patient has painful metabolically active Paget disease of the skull and pelvis, raised alkaline phosphatase, normal renal function and replete calcium and vitamin D. Which treatment offers the most durable response?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — A single intravenous zoledronic-acid infusion

When symptomatic active Paget disease is treated and there is no contraindication, a single intravenous zoledronic-acid infusion produces the most durable biochemical and clinical response. Renal function, calcium and vitamin-D status must be checked before treatment; other antiresorptives are less durable or are not routine first-line therapy.

Reference: Clinical guideline for diagnosis and management of Paget disease of bone (Published March 2019): https://onlinelibrary.wiley.com/doi/10.1002/jbmr.3657; NICE TA464: bisphosphonates for treating osteoporosis (Updated July 2019): https://www.nice.org.uk/guidance/ta464/chapter/1-Recommendations