OSTEOARTHRITIS AND PAGETS-DISEASE

Paget's disease of bone adjacent to the joint margin is thought to cau se accelerated osteoarthritis of the affected joint. By analogy with t he post-meniscectomy knee model, a constitutional tendency to develop osteoarthritis may modify the response to Paget's disease. Sixty-nine patients with Paget's disease extending to include a joint margin were identified in a rheumatological out-patient clinic, and examined clin ically and radiographically. Radiographs were scored according to the method of Kellgren and Lawrence. Paget's disease was found adjacent to 100 joints: 86 hips, 13 knees and one wrist. Osteoarthritis was more severe in ipsilateral, compared to contralateral, joints (Mann-Whitney , P = 0.04). A significant difference in the severity grading of index joints was found between groups based on the presence of osteoarthrit is elsewhere (Mann-Whitney, P = 0.01). In conclusion, accelerated oste oarthritis was found in joints affected by Paget's disease, but this a ssociation may be an overestimate because of selection bias. In additi on, the severity of osteoarthritis in affected joints was related to t he presence of osteoarthritis elsewhere in the patient. Further studie s are required to determine the magnitude of the effect of Paget's dis ease on the adjacent joint.