A radiological survey of Paget's disease of bone

Guyer, Peter Brett (1977) A radiological survey of Paget's disease of bone. University of Southampton, Doctoral Thesis.

Abstract

An epidemiological survey of Paget's disease of bone in 14 British towns, selected according to hospital discharge and mortality data for Paget's disease, has shown a range of prevalence s from 4.20' tip to 7.5 of patients aged 55 or more referred to hospital. There was a concentration of high prevalence in Lancashire totrrts. The survey revealed 1223 patients with Paget's disease, and their K-rays have been analysed for the extent and distribution of skeletal involvement. 90' show disease in the pelvis, lumbar spine and upper ends of the femora, and 31c6 have monostotic disease. Males arc more frequently affected than females. Prevalence and extent of the disease rise with age. Greater involvement of the lower limb than the upper limb, a right sided tendency in the limb girdles, and preferential involvement of certain regions of the spine all suggest that bone stress may be significant in the pathogenesis. Examination of the request cards, X-ray reports, and clinical response to the report, reveals that 3496 of patients had symptons recorded which -ere referable to their bone disease. The type of initial radiological examination appears to be of little relevance to the prevalence of the bc:1e disease. The onset of symptoms uay occasionally be in tile third decade but is rencrail.y Inter. The Main synp I to ysinns, :nd caala `. cation are pain, deformity, fracture, evidence of malignancy, and (rarely) spinal cord compression. The results of this survey suggest that Paget's disease of bone may be due to absorption of an external agent, and that the bone changes arc related to bone stress.

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