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Treatments and drugs
By Mayo Clinic staffIf you have mild fibrous dysplasia that's discovered incidentally and you have no signs or symptoms, your risk of developing deformity or fracturing your bone is low. Your doctor can monitor your condition with follow-up X-rays every six months. If there's no progression, you don't need treatment.
If you develop signs and symptoms, treatment may include medications or surgery.
Bisphosphonates
Medications called bisphosphonates, including pamidronate (Aredia) and alendronate (Fosamax), are used to inhibit bone breakdown, preserve bone mass and even increase bone density in your spine and hip, reducing the risk of fractures. Doctors use these medications primarily for adults to treat osteoporosis and increase bone density, but bisphosphonates may also reduce bone pain associated with fibrous dysplasia and, in some cases, improve bone formation.
Little is known about the use of bisphosphonates for children and adolescents, but some studies indicate they may help relieve pain in children and adolescents with severe fibrous dysplasia.
Oral bisphosphonates are generally well tolerated, but may irritate your gastrointestinal tract. Some bisphosphonates aren't available as oral medications, and you must receive them through a vein (intravenously). The drug tends to work faster when you receive it through a vein than if you take it orally, and intravenous administration provides an option when you can't tolerate or otherwise aren't a candidate for oral bisphosphonates. You can't take bisphosphonates if you have serious kidney disease or low blood-calcium levels.
Surgery
Your doctor may recommend surgery in order to:
- Correct a deformity
- Fix a fracture
- Remove an affected area of bone (lesion) that's causing you difficulty
- Relieve pressure on a nerve, particularly if the lesion is in your skull or face
Surgery may involve removing the bone lesion and replacing it with bone grafted from another part of your body or from donated cadaver bone tissue. Your surgeon may insert metal plates, rods or screws to stabilize the bone and the graft. Risks include infection, blood clots and bleeding. In addition, a bone graft may not last.
- Fibrous dysplasia. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00083. Accessed May 11, 2009.
- DiCaprio MR, et al. Fibrous dysplasia. Pathophysiology, evaluation, and treatment. The Journal of Bone & Joint Surgery. 2005;87:1848.
- Leet AI, et al. Current approach to fibrous dysplasia of bone and McCune-Albright syndrome. Journal of Children's Orthopaedics. 2007;1:3.
- Polyostotic fibrous dysplasia. Craniofacial & Skeletal Diseases Branch, Division of Intramural Research, National Institute of Dental and Craniofacial Research. http://csdb.nidr.nih.gov/frame_clinical_bkg.htm. Accessed May 11, 2009.
- Glorieux FH, et al. Medical therapy of children with fibrous dysplasia. Journal of Bone and Mineral Research. 2006;21(suppl):P110.
- Chapurlat RD, et al. Fibrous dysplasia of bone and McCune-Albright syndrome. Best Practice & Research Clinical Rheumatology. 2008;22:55.
