A treatise on orthopedic surgery . cal osteomalacia —is present. Local weakness and deformity may be caused by injury or bysubacute osteomyelitis and the like. If there is a distinct localdisease that deserves the name of local osteomalacia its causehas not been determined. OSTEITIS DEFORMANS. This disease was first described by Paget^ in 1877. It is achronic inflammatory affection of the bones, characterized byhypertrophy and softening. The bones enlarge, soften, andthose bearing weight become unnaturally curved and mis-shapen. ^ Med. Chir. Trans., Vols. xl. and Ixv. 532 OBTHOPEDIC SUSGEBY. S
A treatise on orthopedic surgery . cal osteomalacia —is present. Local weakness and deformity may be caused by injury or bysubacute osteomyelitis and the like. If there is a distinct localdisease that deserves the name of local osteomalacia its causehas not been determined. OSTEITIS DEFORMANS. This disease was first described by Paget^ in 1877. It is achronic inflammatory affection of the bones, characterized byhypertrophy and softening. The bones enlarge, soften, andthose bearing weight become unnaturally curved and mis-shapen. ^ Med. Chir. Trans., Vols. xl. and Ixv. 532 OBTHOPEDIC SUSGEBY. Section of an affected bone shows it to be markedly increasedin size, and somewhat in length, by a combination of rarefyingand formative osteitis. The inner layers become porous, and atthe same time new bone is deposited beneath the periosteum. The disease appears to be confined to adult life, and it isapparently more common among males than females. Of 67cases collected by Packard, Steele, and Kirkbride,-^ 61 per cent. Fig. Osteitis deformans in a female seventy-three years of age. () As a rule, the lesions are symmetrical and general in dis-tribution, the bones of the lower extremity, the skull, and thespine being more often involved. Thus the head progressivelyincreases in size, and the legs become bowed. If the spine isaffected it bends forward, forming a long, more or less rigidkyjDhosis. Aside from the deformities and the characteristic enlarge-ment of the bones, the symptoms are not marked. At times com-plaint is made of pain usually supposed to be rheumatic untilthe characteristic changes in the bones appear. The disease isextremely chronic in its course, and, as a rule, the generalhealth is not seriously affected. In several instances sarcomaof bone finally caused death many years after the onset of thedisease. Its etiology is unknown, and its treatment is palliative. Local Osteitis Deformans.—^A disease resembling in its gen-eral characteristics osteiti
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