Paget’s Disease of Bone (Osteitis Deformans)
Abstract
It is now more than sixty years since Sir James Paget1 described the bone disease which bears his name. He advocated the term “osteitis deformans”, but this would seem to be a misnomer. We do not believe infection to be concerned in the cause, and we know that in many cases there is no skeletal deformity. Therefore, we prefer to designate it “Paget’s disease”. A summary of the salient features encountered and the present-day concepts of the disease, together with a review of 48 cases recorded at the Cleveland Clinic, are presented.
The advanced stages present a striking picture of skeletal changes, and the classic cases with the massive but well-formed head, reduced stature with marked kyphosis, the great anterior bowing of the legs and the pendulous abdomen present no difficulty in diagnosis. These cases are uncommon and the frequently diagnosed ones are much less advanced, perhaps involving but one bone. It is in these early or localized lesions that the differential diagnosis becomes more formidable and important.
INCIDENCE AND DISTRIBUTION
Paget’s disease is frequently recognized now. Brailsford2 was able to collect only 300 cases which had been recorded prior to 1926. He added 154 cases of his own in 1936 and since that time many others have been reported. Forty-eight cases have been diagnosed and recorded at the Cleveland Clinic.
Paget’s disease is essentially a disease of late life, perhaps later than the average carcinoma age, although in most cases the disease has been present some years before it. . .
