Rheumatology Advance Access originally published online on January 6, 2005
Rheumatology 2005 44(2):261-262; doi:10.1093/rheumatology/keh448
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Rheumatology Vol. 44 No. 2 © British Society for Rheumatology 2005; all rights reserved
LETTER TO THE EDITOR |
Paget's disease of bone: osteitis deformans or osteodystrophia deformans?
Department of Rheumatology, The Royal London Hospital, Bancroft Road, London E1 4DG, UK
Correspondence to: A. S. M. Jawad. E-mail: alismjawad1{at}hotmail.com
Sir, We read with interest the review of Paget's disease by Langston and Ralston [1]. We are pleased that, unlike many authors, they resisted the urge to refer to this condition as ‘osteitis deformans’.
Originally described by Sir James Paget in 1877, he mistakenly believed it was an inflammatory condition of bone, hence his term ‘osteitis deformans’ [2]. As Langston and Ralston highlight, the pathology is now known to be disordered bone turnover with no inflammatory component and so Paget's’ original description is inaccurate. Despite this, the term ‘osteitis deformans’ remains widely used, a Medline search revealing several hundred references over the last few years.
The term ‘osteodystrophia deformans’ is less widely known as a description of Paget's disease. A Medline search of this term suggests its use in non-English literature only, in particular in Germany. It would, however, appear to be a much more accurate description of the underlying pathology of this condition. It is not mentioned or listed in a comprehensive monograph on Paget's disease of bone [3]. The term ‘osteitis deformans’ is referred to in the foreword and the preface [3].
In general, the avoidance of eponymous names is preferable, although in the absence of better descriptive names they remain widely used in rheumatological practice. Examples include Scheuermann's disease (juvenile osteochondrosis of the vertebral bodies or adolescent kyphosis), Blount's disease (juvenile osteochondrosis of the medial aspect of the proximal tibial epiphysis or tibia vara) and Thiemann's disease (juvenile epiphyseal disturbance). These names provide an interesting link with our medical heritage but in an age when medical literature is accessible globally they may cause confusion if not widely recognized. ‘Osteitis deformans’ is clearly an inaccurate description and we believe ‘osteodystrophia deformans’ deserves to be far more widely recognized within the English language medical literature. Nonetheless, we expect ‘Paget's disease of bone’ will stay with us for many more years.
The authors have declared no conflicts of interest.
References
- Langston AL, Ralston SH. Management of Paget's disease of bone. Rheumatology 2004;43:955–9.
[Abstract/Free Full Text] - Paget J. On a form of chronic inflammation of bones (osteitis deformans). Trans Med-Chir Soc 1877;60:255–36.
- Kanis JA. Pathophysiology and treatment of Paget's disease of bone, 2nd edn. London: Martin Dunitz, 1998.
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