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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.
Medications
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. If you can't tolerate oral bisphosphonates or if your doctor recommends a drug that's not available in oral form, you may receive bisphosphonates through a vein (intravenously). 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
- Correct a difference in limb lengths
- 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 bone tissue donated from a deceased donor. 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 June 3, 2011.
- Tis JE. Overview of benign bone tumors in children and adolescents. http://www.uptodate.com/home/index.html. Accessed June 3, 2011.
- Whyte MP. Osteonecrosis, osteosclerosis/hyperostosis, and other disorders of bone. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed June 3, 2011.
- Rosenberg AE. Bones, joints and soft-tissue tumors. In: Kumar V, et al. Robbins and Cotran Pathologic Basis of Disease. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4377-0792-2..50031-6--cesec46&isbn=978-1-4377-0792-2&sid=1166563817&uniqId=255806599-7#4-u1.0-B978-1-4377-0792-2..50031-6--cesec64. Accessed June 3, 2011.
- Chapurlat RD, et al. Treatment of fibrous dysplasia of bone with intravenous pamidronate: long-term effectiveness and evaluation of predictors of response to treatment. Bone. 2004;35:235.
- Joglekar SB (expert opinion). Mayo Clinic, Rochester, Minn. June 18, 2011.
- Sim FH (expert opinion). Mayo Clinic, Rochester, Minn. June 18, 2011.
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