Skeletal Blood Flow in Paget's Disease of Bone and its Response to Calcitonin Therapy

Abstract

1. Blood flow to the skeleton was measured by the 18F clearance method of Wooton, Reeve & Veall (1976) in 24 patients with untreated Paget's disease. In every patient but one, resting skeletal blood flow was increased. There was a significant positive correlation between skeletal blood flow and serum alkaline phosphatase and between skeletal blood flow and urinary total hydroxyproline excretion. 2. Fourteen patients were re-studied after they had received short-term (7 days or less) or long-term (7 weeks or more) calcitonin. Skeletal blood flow, alkaline phosphatase and urinary hydroxy-proline excretion fell towards normal in every case. There was some evidence from the short-term studies that calcitonin produced a more rapid fall in skeletal blood flow than in alkaline phosphatase. 3. Glomerular filtration rate appeared to increase transiently in response to calcitonin.

Mechanisms of bone loss in rheumatoid arthritis

“…They found that skeletal blood flow (SBF) in untreated Paget's disease of bone was strikingly increased in proportion to the biochemical severity of the disease. Treatment with calcitonin brought a rapid return to normal, 85 which was postulated to explain the rapid pain relief often reported on starting treatment with calcitonin. Likewise, treatment with sodium etidronate reduced the SBF and the responses of patients correlated well with the their reductions in serum alkaline phosphatase.…”

“…81 The vasculature is also important in bone metabolism and bone turnover. The elegant work of Reeve and coworkers persuasively demonstrated a relationship between blood flow and bone turnover 85 and indicated that bone can regulate its own blood flow. They developed a method of measuring blood flow in bone that depends on the complete extraction of 18 F in a single passage through bone.…”

A Prospective Study of Risedronate on Regional Bone Metabolism and Blood Flow at the Lumbar Spine Measured by18F-Fluoride Positron Emission Tomography

“…(2,20) This is the first study to date to examine changes in fluoride kinetics at the lumbar vertebrae after antiresorptive therapy; therefore, these results cannot be directly compared with others. However, Wootton et al, (33) using an 18 Ffluoride clearance technique, reported a significant decrease in total skeletal blood flow after treatment with calcitonin therapy, an antiresorptive agent, in patients with Paget's disease. In the study by Messa et al, (18) it was reported that, in three patients undergoing therapy for renal disease, K i assessed by Patlak analysis decreased in two of the three patients after calcitriol therapy.…”

Remission of Psoriasis with Etidronate Treatment of Underlying Paget’s Disease of Bone

“…Bone affected by Paget's disease has in creased blood flow, and this returns to nor mal with treatment [4], The skin overlying bone with active Paget's disease is often erythematous and warm [5] because of vasodilation of the cutaneous blood vessels and increased blood flow [6]. This too reverses with treatment.…”