Paget's Disease of Bone Its Frequency, Diagnosis, and Complications

The disease which I propose to try and interest you in to-night is that which Sir James Paget described as Osteitis Deformans, in 1877. He used the term because he believed that the skeletal deformities were due to an osteitis or inflammatory condition of the affected bones; in fact, the title of his monograph is, “On a form of Chronic Inflammation of Bones (Osteitis Deformans).” We now know that inflammatory conditions of bone can lead to deformation, though such conditions may present little resemblance, either clinically or radiographically, to the entity described by Paget, and the evidence which we have before us does not lead us to regard the disease described by him as one of inflammation of bone such as we see as the result of bacterial invasion. Cases presenting some of the clinical features we see in Paget's disease had previously been described; even the term Osteitis Deformans had been coined by Czerny, in 1873, but none of these earlier descriptions of patients give us the characteristic picture of the disease which was so ably drawn by Paget to its intimate detail. Even Paget stated, in his account, that he believed the disease to be so rare that “no one has seen a sufficient number of them to enable him to distinguish the disease, either clinically or anatomically, from some which seem like it.”