Renier J C, Leroy E, Audran M
Department of Rheumatology, Teaching Hospital, Angers, France.
Rev Rhum Engl Ed. 1996 Dec;63(11):823-9.
We retrospectively evaluated the initial site of bone lesions in 200 patients with Paget's disease. There were 117 males and 83 females. Mean follow-up was 13 years in 98 patients. The initial site can be determined accurately only if less than one third of the bone is involved. Paget's disease usually begins in the cancellous bone of an epiphysis or metaphysis. A diaphysis is the first site involved in some instances, and the anterior subperiosteal area of the proximal half of the tibia in a very small number of cases. The distribution of initial pagetic lesions in our series is reported for each of the main bones. Lesions usually arose in the proximal ends of long bones, which are richly vascularized but contain no hematopoietic marrow in adults. This suggests that the distribution of pagetic lesions may be more closely dependent on local circulatory conditions than on the presence of hematopoietic marrow, which is, however, the only source of osteoclasts.
我们回顾性评估了200例佩吉特病患者骨病变的初始部位。其中男性117例，女性83例。98例患者的平均随访时间为13年。只有当累及的骨组织少于三分之一时，才能准确确定初始部位。佩吉特病通常始于骨骺或干骺端的松质骨。在某些情况下，骨干是首先受累的部位，在极少数情况下，胫骨近端一半的前骨膜下区域是首先受累的部位。我们报告了本系列中每个主要骨骼初始佩吉特病变的分布情况。病变通常发生在长骨的近端，这些部位血管丰富，但在成年人中不含造血骨髓。这表明佩吉特病变的分布可能更依赖于局部循环状况，而不是造血骨髓的存在，然而，造血骨髓是破骨细胞的唯一来源。
