Osteitis deformans (Paget's disease) / by W. Gilman Thompson.

  • William Gilman Thompson
Date:
1913
Catalogue details

Licence: In copyright

Credit: Osteitis deformans (Paget's disease) / by W. Gilman Thompson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    shows them to be irregularly hypertrophic, being thickest in the upper two thirds, and thinnest at the junction of the middle and lower third. The humeri, particularly*the left one, are in like manner bowed outward and irregularly hypertrophied. Fig. 3. The bones of both forearms and legs and the clavicles present similar enlargement and distor- tion, but in lesser degree. The ribs are unaffected, as well as the bones of the hands and feet. The cranial vault is exaggerated and the parietal and frontal bones especially are broad, thick, and grossly uneven on the surface. The postero- temporal and parietal regions are so prominent as to depress the ears and give the face and head a wedge shape. This is accentuated by a narrow- pointed protuberant inferior maxilla. Such an ex- treme case is easily distinguished from rickets. There is no deformity of the sternum, beading of the ribs, enlargement of the epiphyses or cranio- tabes, and the .;r-ray pictures are diagnostic in show- ing the irregular hypertrophic osteitis, particularly of the cranium, humeri, and femora. Furthermore, the disease has developed during adult life. The general health of the patient is excellent. She is entirely free from pain or tenderness over the alfected bones, and the detailed physical exam- ination of the viscera reveals no abnormality ex- cepting in the heart a slight mitral regurgitation. There is, however, advanced arteriosclerosis and the blood-pressure averages 170 mm. There is no ab- normal pigmentation of the skin or hypertrophy of the soft parts such as is usually observed in acromegaly. The Wassermann reaction is negative. None of the numerous theories to explain the origin of osteitis deformans has met with general acceptance. It is true that a majority of those who