Which of the following structures are commonly affected in Paget disease?

AIIMS M.Sc. Nsg Entrance exam-2026

Medical Surgical Nursing

Easy

Appeared in: AIIMS M.Sc. Nsg Entrance exam-2026

Explanation

Paget disease has a strong predilection for the axial skeleton.
The axial skeleton includes the pelvis, vertebral bodies (spine), and skull, which are the most frequently involved sites in Paget disease.
Studies and clinical observations show that the pelvis is affected in up to 75% of cases, and the spine and skull are also very common sites.
Therefore, the 'axial skeleton' is the most accurate and comprehensive answer describing the primary location of the disease.

Option A: The short bones of the hands and feet are very rarely affected by Paget disease. The disease process favors larger bones with higher rates of bone turnover.
Option C: While the skull (cranium) is a common site, the facial bones are involved less frequently. Skull involvement can lead to enlargement (frontal bossing) and complications like hearing loss, but this is distinct from primary facial bone disease.
Option D: The appendicular skeleton consists of the limbs. Although some of its long bones, like the femur and tibia, are commonly affected, this option is less complete than 'axial skeleton'. It excludes the pelvis and spine, which are the most frequent sites of all.

Visual 1: Diagram - A diagram of the human skeleton with the most common sites of Paget disease highlighted in red (pelvis, spine, skull, femur, tibia). This helps visualize the distribution of the disease.
Visual 2: X-ray Image - An X-ray of a pagetic bone (e.g., femur or skull) showing characteristic features like cortical thickening, bone expansion, and mixed lytic and sclerotic lesions ('cotton wool' appearance in the skull).

Clinical Relevance

Nursing practice connection: Knowing Identifying the most commonly affected skeletal structures in Paget disease (Osteitis Deformans) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses should be aware that patients with Paget disease, especially involving weight-bearing bones, are at high risk for pathological fractures. Safe mobilization and fall prevention are critical nursing interventions.
Pain management is a key aspect of care. The pain can be from the pagetic lesion itself, secondary osteoarthritis, or nerve compression.
Monitoring for neurological changes is crucial. For example, a patient with skull involvement should be assessed for hearing loss, headaches, or changes in vision, which could indicate cranial nerve compression.

How to Approach the Question

First, identify the core subject of the question: 'Paget disease' and what it 'commonly affects'.
This is a factual recall question. Access your knowledge about the pathophysiology of Paget disease.
Recall or look up the typical distribution of pagetic lesions in the skeleton.
Evaluate the given options: 'Short bones of the hand', 'Axial skeleton', 'Facial bones', and 'Appendicular skeleton'.
Compare the options. While the appendicular skeleton can be affected, the axial skeleton (pelvis, spine, skull) is the most classic and frequent site. The other options are either rare or less common.
Select the option that most accurately and comprehensively describes the most common sites of involvement.

Concept Tested & Keywords

Concept Tested: Identifying the most commonly affected skeletal structures in Paget disease (Osteitis Deformans).
Stem keywords: Paget disease, structures, commonly affected
Lead-in keywords: Which

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