Objective: To evaluate the prevalence in France of Paget's disease in elderly women.
Patients and methods: The prevalences of Paget's disease and of thoracic and lumbar vertebral hemangioma were determined in a random nested cohort of 770 women from the EPIDOS study cohort. EPIDOS is a prospective study of the risk of proximal femoral fracture in 7,598 female, community-dwelling volunteers older than 75 years of age. The EPIDOS study patients were recruited at five centers in France (Amiens, Lyon, Paris, Montpellier, and Toulouse). For the nested study, anteroposterior and lateral radiographs of the thoracic and lumbar spine were read by two rheumatologists and classified into four groups: no Paget's disease or hemangioma, possible Paget's disease or hemangioma, definite Paget's disease, and definite hemangioma. Radiographs in the last three groups were read by a rheumatology professor and a radiology professor, both independent from the study.
Results: Twenty-five patients had incomplete or poor-quality radiograph sets, leaving 745 patients for the study. A vertebral hemangioma was found in four patients (0.54%; 95% confidence interval [CI], 0.01-1.1%) and vertebral Paget's disease in four other patients (0.54%; 95% CI, 0.01-1.1 %). All the pagetic vertebrae were at the lumbar spine. Three of the four Paget's disease patients were unaware of the condition before their inclusion in the study. Based on previous estimates that thoracic and lumbar foci are present in 30 to 50% of Paget's disease patients, our data suggest that the overall prevalence of Paget's disease in French women older than 75 years may be in the 1.1-1.8% range.
Conclusion: The prevalence of Paget's disease in elderly French women is similar to that recently reported in Britain.