When should I consider referring a patient with Paget's disease of bone to a specialist?

Consider referring a patient with Paget's disease of bone to a specialist if they present with bone pain or deformity suggestive of the disease. Specialist referral is appropriate to confirm diagnosis, exclude other causes, and manage complications or treatment.

Referral is particularly important if there are symptoms or signs that suggest complications such as fractures, neurological symptoms, or suspicion of malignancy (e.g., sarcoma transformation).

Additionally, if the diagnosis is uncertain or if the patient has complex symptoms requiring specialist input, referral to an appropriate secondary care physician (such as an endocrinologist or metabolic bone specialist) is advised.