What additional finding would typically be associated with a diagnosis of Paget's disease of bone?

Paget's disease of bone is characterized by accelerated bone remodeling, leading to the disorganized structure of bones. One of the most notable laboratory findings in this condition is the elevation of alkaline phosphatase levels. Alkaline phosphatase is an enzyme produced by osteoblasts (bone-forming cells), and its level rises in response to increased bone turnover.

In Paget's disease, due to the excessive activity of osteoclasts (bone-resorbing cells) followed by an increase in osteoblastic activity, the alkaline phosphatase levels reflect the dysregulated bone metabolism. Clinically, patients with Paget's disease may present with bone pain, deformities, and complications such as fractures, but the high alkaline phosphatase level serves as a key biomarker that supports the diagnosis.

Other potential findings listed, such as elevated serum calcium, might occur in different conditions (e.g., hyperparathyroidism or malignancy) but are not typically indicative of Paget's disease. Similarly, increased serum phosphate levels are usually not associated with Paget's disease; in fact, phosphate levels can be normal or low, and vitamin D levels can vary independently of the disease state. Thus, the association of high alkaline phosphat