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

  • Thompson, W. Gilman (William Gilman), 1856-1927.
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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    All arguments considered, the conclusion of An- dre Chastel, who reports two cases in his Paris Thesis of 1910, appears justified, namely, that os- teitis deformans is an independent, well-defined dis- ease, “the theory of the etiology of which has yet to be established.” In the few cases in which meta- bolism observations have been conducted, nothing distinctive has been determined, possibly because they have not been conducted over long enough periods for so chronic a disease. The most comprehensive study of the disease published since Sir James Paget’s original account is given by Jules Vincent in his Paris Thesis of 1904, (Maladie ossieuse de Paget) in which he pre- sents an interesting discussion of previous articles, and includes eight new cases, several of which are pictured. This writer, emphasizing the early nerve symptoms of the disease, namely the muscular cramps, fatigue pains, exaggerated reflexes, and oc- casional incontinence of urine and local hyperther- mia, inclines to the hypothesis that the disease may originate as a central trophoneurosis, although in the few autopsies which have been made, a thor- ough study of possible pathological changes in the nervous system has not been undertaken. Follow- ing is a brief summary of the pathological anatomy of the disease as given by those who have oppor- tunity to perform necropsies. The muscles attached to the affected bones are pale and atrophic, and the ligaments occasionally have been found ossified. In the earliest stage of the disease the bone tissue appears somewhat soft and fragile, but as the disease advances it becomes firm. The periosteum may remain normal or ex- hibit increased vascularity. In stripping it, adja- cent portions of bone tissue are sometimes detached.