A 63-year-old White man presents with bowing deformity of his legs, gait abnormality, and tingling and weakness in his left leg. The nurse practitioner suspects Paget’s disease of bone (PDB). Which of the following most closely describes the pathophysiology of PDB?

PDB is a progressive disease that damages or destroys synovial joint structure and articular cartilage of the joints.

Excess osteoclastic activity is followed by compensatory osteoblastic activity, leading to the formation of bone that is less compact, mechanically weaker, and more susceptible to fracture.

PDB is an autoimmune disorder in which inflammation of the synovium leads to joint destruction and deformity.

PDB is caused by an imbalance of bone resorption and bone remodeling that leads to decreased skeletal mass.