Paget's disease of bone in West Germany. Prevalence and distribution

In the region of Baden-Württemberg, 6751 doctors (general practitioners, internists, surgeons, and orthopedists) were asked to report on patients in their practice with Paget's disease of bone. Two hundred forty-nine doctors reported on 325 cases of Paget's disease, half of which were regarded as needing treatment. Since the authors' unit received 47 Paget patients in Baden-Württemberg and about half of them were registered during the investigation, it can be concluded that around 300 patients with clinically significant disease needing treatment are known. They represented only 0.25% of an estimated 120,000 cases of Paget's disease in people older than 40 years of age expected among the 4.03 million people of this age group. Analysis of the epidemiologic data from 103 cases of Paget's disease of bone revealed an equal sex distribution (51 men and 52 women), but age at diagnosis was about one decade earlier in men. The anatomic distribution showed most often involvement of pelvic bones, followed by femora, calvarium, tibiae, and lumbar vertebrae. Right-sided preference was not evident, but the distribution favors the suggestion that physical stress may be a factor or cofactor in the clinical manifestations of the disease.