1902.] WILSOX — OSTEITIS DEFORMANS. 143 



A BRIEF ACCOUNT OF THE DISEASE KNOWN AS 

 OSTEITIS DEFORMANS. 



BY PROF. J. C. WILSON, M.D. 

 {Read April 5, 1902.) 



It will, I trust, be acceptable to the Society if I communicate 

 some facts in regard to a rare disease of the bones. 



This affection was first described by Sir James Paget, in the 

 Transactions of the Royal Afedical and Chirurgical Society of Lon- 

 don, in 1877, under the title '^ A Form of Chronic Inflammation of 

 Bones — Osteitis Deformans." To the five cases which formed the 

 basis of that communication, Paget was able to add in 1890 

 eighteen further instances of the disease which he had studied. 

 Other cases have been observed in Great Britain ; in America up to 

 the present time eleven cases have been reported ; a number in 

 France, and a few elsewhere on the Continent of Europe. 



It is, however, probable that osteitis deformans is much more 

 common than the number of the published cases would indicate. 

 In the preliminary program of the Association of American Physi- 

 cians just issued two new cases are announced. The fact that the 

 disease remained long undescribed and is now so seldom recognized, 

 is due not so much to the infrequency of its occurrence as to the 

 trifling subjective symptomiS which attend it or their complete 

 absence, its insidious development and slow progress, and the im- 

 munity of the bones of the hands and feet. The sufferer from 

 osteitis deformans may develop advanced changes in the skeleton 

 before the deformities attract his attention or that of his friends. 



The deformities in some instances affect only a limited number 

 of the bones, more commonly most of them. In the fully developed 

 disease they are usually symmetrical to a remarkable degree. 



They consist in the following changes in the skeleton: 



Thickening of the bones of the skull and an alteration in its 

 shape. The calvarium becomes flattened, the brow broad, the 

 parietal regions prominent. The general circumference is increased 

 so that the patient has to wear a larger cap than formerly. The 

 bones of the face remain unchanged, so that the facies assume a 

 triangular outline, the base being at the brow, the apex at the chin. 



The spine becomes stiffened and curved. There is marked 

 cervico- dorsal kyphosis, with compensating lordosis of the lower 



