A client presented to the emergency department after getting "hit in the head with a baseball" while watching his grandson play. An x-ray of the head reveals poor quality of bone
The ED physician suspects the client has Paget disease. Which of the following signs/symptoms helps confirm this diagnosis? Select all that apply.
A) "I've had a lot of headaches lately."
B) "Every now and then, I get a ringing in my ears."
C) "Do you see my knuckles…they have big growths on them."
D) "My thumb joint has been cracking every time I rotate it."
E) "I have gotten dizzy and had to sit down while shopping."
Ans: A, B, E
Feedback:
Skeletal expansion and distortion may be obvious if the disease affects the skull, jaw, clavicle, or long bones of the leg. Involvement of the skull causes headaches, intermittent tinnitus (ringing in the ears), vertigo (dizziness), and eventual hearing loss. The abnormal knuckles and thumb joint are related to arthritis.
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