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THE PATHOLOGY OF OSTEITIS DEFORMANS, PAGET'S DISEASE
SYDNEY M. CONE
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The Pathological Laboratory of the University of Maryland.
The Journal of Bone & Joint Surgery.  1922; 4:751-788 
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Abstract

We have, then, osteoporosis with disappearance of bone by lacunar absorption and chemical (vital fluid?) dissolution, accompanied by new formation of bone. In my case the new formation is not so marked as in those reported by others. The active process seems to have been completed.

There is evidence of breaking down of bone—I would say bending of trabeculae crushing down on neighboring cancelli, obliterating some canals and assisting in the formation of others.

There is marked vascular degeneration with varicose vessels, thrombosis, congestion, leakage with edema and minute hemorrhages. The surrounding tissues are modified to a certain extent as evidenced by changes in vessels, nerves, muscles, and tendons. It is suggested that this is due to the bone absorption in their neighborhood throwing them in contact with unaccustomed (unusual) neighboring material. In the case of muscle attachments the distortion and microscopical changes are especially marked.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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