Pathophysiology of Paget's Disease of Bone

Exclusion Criteria

• •Osteosarcoma or other blastic bony metastases alone
• •Fibrous dysplasia of bone
• •Hyperostosis frontalis interna
• •All men and women \< 18 years or \> 99 years
• •Pregnancy (women) determined by self-report
• •Current use of oral contraceptive tablets or Depo-Provera™ (women)
• •Current use of hormone replacement therapy
• •Creatinine clearance \< 60 ml/min./1.73 m2 by Cockcroft-Gault based on most recent serum creatinine level (if greater than 1 year since last assessment, will be measured on collected blood sample to verify eligibility)
• •Current smoking or tobacco use
• •Alcohol use greater than 3 units daily
• •Use of thiazolidinediones within the last year
• •Use of medications known to impact bone and mineral metabolism, including use of a bisphosphonate in the last 11 months; ever use of teriparatide or denosumab; use of calcitonin, selective estrogen receptor modulators (SERMs), or estrogen within the past 6 months, prednisone \> 5 mg for over 10 days in the last three months, anti-epileptic medications (e.g. phenytoin, carbamezapine, phenobarbitol, and primidone); current or use within the past year of aromatase inhibitors; leuprolide; histrelin
• •History of a thyroid problem that is currently uncontrolled as defined by most recent thyroid stimulating hormone levels \< 0.1 microIU/mL (if greater than 6 months since last assessment, will be measured on collected blood sample to verify eligibility)
• •Other known metabolic or structural bone disease other than low bone density (e.g. hyperparathyroidism, multiple myeloma, sarcoid or other granulomatous disease, celiac disease, osteopetrosis, osteomalacia, osteitis fibrosa cystica)
• •Other significant medical illness (heart disease, pulmonary disease, inflammatory bowel disease, malignancy other than ductal carcinoma in situ (DCIS) or non-melanoma skin cancer, rheumatologic conditions including rheumatoid arthritis, systemic lupus, renal disease requiring dialysis, etc.)
• •Inability to understand and provide informed consent.