COEXISTENCE OF PAGETS BONE-DISEASE AND DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS IN MALES

The coexistence of Paget's bone disease (PBD) and diffuse idiopathic s keletal hyperostosis (DISH) of the spine is controversial and could ha ve implications for the pathogenic mechanisms involved in these disord ers. In order to assess the prevalence of DISH in patients with Paget' s disease, a prospective controlled study was carried out in which roe ntgenograms were obtained from a group of 50 consecutive ambulatory pa tients previously diagnosed as having PBD (25 males and 25 females; me an age: 66.2 +/- 8.9 years) and these were compared with 50 age- and s ex-matched subjects selected randomly from various categories of medic al disorders excluding PBD. DISH was found in 12 of 50 Paget's patient s, this corresponding to an incidence of 24%; 10 (83%) of these 12 sub jects were males. In the control population the incidence of DISH was 6% - 2 males and 1 female. This difference between the two groups was statistically significant (X2 test, p = 0.02). Apart from the male gen der, which was clearly associated with the presence of DISH in the Pag et's group (p = 0.019), no other biological variable or characteristic of PBD was linked to the presence of DISH. In conclusion, our data re vealed that PBD patients have a significantly greater prevalence of DI SH than non-PBD probands. It would seem that the genetic mechanism whi ch is responsible for the susceptibility of PBD to osteoclast viral in fection could be related to the pathogenia of DISH in a sex-linked man ner.