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Paget's disease of bone, osteogenesis imperfecta, and fibrous dysplasia.

These disorders are seen both by physicians and by orthopaedic surgeons, and each may have a different view of them. The physician may be interested in Paget's disease because of its biochemical changes and the possibility of altering them, where as the orthopaedic surgeon may regard it as a common disorder of bone that makes surgery difficult. The physician finds interest in osteogenesis imperfecta because it is an inherited metabolic disorder; the surgeon because of the deformities and surgical problems it produces. Fibrous dysplasia means to the physician the rare multisystemic polyostotic disease with pigmentation and sexual precocity (Albright's syndrome); the orthopaedic surgeon thinks of the commoner monostotic form apparently limited to bone. The most recent advances have been in the first two disorders; to understand them it is helpful to have some idea of collagen chemistry.