What clinical clues may indicate Paget's disease?

Paget's disease of bone is a chronic disorder that can result in enlarged and deformed bones due to abnormal bone remodeling. The clinical clues that suggest this condition often include age-related factors, laboratory findings, and specific symptoms.

Older patients typically present with Paget's disease, as it most commonly affects adults over the age of 50. Elevated alkaline phosphatase levels are significant because this enzyme is often elevated in conditions involving increased bone turnover, such as Paget's disease. Additionally, patients may experience deep bony pain due to the excessive formation of abnormal bone, which can lead to complications such as osteoarthritis or fractures.

These clinical indicators—age, elevated alkaline phosphatase levels, and deep bony pain—provide a strong suspicion for the diagnosis of Paget's disease and guide further evaluation and management. Other options do not align closely with the typical presentation of Paget's disease, which is why they are less suitable in this context.