Date amended:
External
Statements of Principles

Fracture - Paget's disease Factor

Signs and symptoms
  • Onset is frequently insidious.  The disease is usually discovered in an asymptomatic patient when routine blood tests show an elevated alkaline phosphatase, or when X-rays are taken for other reasons.
  • However, a patient may seek medical attention for a bony deformity such as bowing of the tibia or femur, enlargement of the skull, shortened stature or for severe aching in the affected bones.
  • Any bone can be involved but the most common sites are the pelvis, femur, skull, tibia, vertebrae, clavicle, and humerus.
Establishing onset

Although onset is frequently insidious, a history of Paget's disease will be documented in the evidence.  However, the veteran or member may not have sought medical attention until some time after the onset of symptoms or signs.  If doctors' and hospitals' records have been destroyed or can no longer be obtained and there is reliable history of appropriate medical treatment at a particular time will generally be accepted, unless there is contradictory evidence.  Seek medical advice if it is unclear whether the symptoms claimed to be due to Paget's disease at that time were not due to some other condition.

Last reviewed for CCPS 24 May 2007.

Preliminary questions [5634]

5688     there is some evidence that Paget's disease may be a factor in the development of the condition under consideration.

5689     the veteran has had Paget's disease of bone at some time.

30223 the veteran has had Paget's disease involving side and site of the body at some time.

5698     the veteran had Paget's disease involving side and site of the body at the time of the clinical onset of the condition under consideration.

5692     the veteran has established the causal connection between Paget's disease and VEA service for the clinical onset of the fracture.

5694     the veteran has established the causal connection between Paget's disease and operational service for the clinical onset of the fracture.

or

5695     the veteran has established the causal connection between Paget's disease and eligible service for the clinical onset of the fracture.

Clinical onset and operational service [5694]

5699     the Paget's disease of bone is causally related to operational service.

Clinical onset and eligible service [5695]

5700     the Paget's disease of bone is causally related to eligible service.