METABOLIC STUDIES IN A CASE OF OSTEITIS DEFORMANS*

Abstract

OSTEITIS deformans was first described by Sir James Paget of Lon don in 1876.Although uncommon, it can hardly be regarded as a rare disease. In 1915, Da Costa et al. (1) reviewed the literature and found 213 cases, including 5 amongst their own records. Since then, the literature has greatly increased; there are to date 245 additional references. In 1925, Lewin (2) stated there were about 251 cases in the literature and on this basis Van Hazel and Andrews (3) concluded that the disease was rare. Since there were 213 cases prior to 1915, it would appear, according to Lewin's observation, that 38 cases only were reported between 1915 and 1925. As a matter of fact, the writer found 115, bringing the total number to 328 to the end of 1924. Since then 206 other cases have been reported, making a total of 534 to date. That the incidence of this disease is probably still greater is suggested from the rate of increase with the more general use of X-Rays. As is well known, X-Rays afford practically the only means of detecting this disease in its very early stages. With still more general use of this laboratory procedure, it appears reasonable that the incidence of this disease will probably be found to be still greater. From the available literature, it is difficult to arrive at the true age and sex incidences, because these factors have received relatively little con sideration in a large number of reports. A common practice appears to have been to report one case in detail and mention incidentally only the number of other cases met with. However, from the available data, the ages ranged from 6 to 89 years; the average was 56.8 years. There appeared to be more males than females; the ratio was about 1.5 to 1. The pathology of this disease has frequently been dealt with in detail and, for purposes of brevity, will not be discussed here, except for relevant facts in the interpretation of our data. This communication is concerne