1. An analytical study of eighty histologically proven cases of Paget's sarcoma confirms and elaborates existing knowledge of the etiology of this tumour. The frequency with which this tumour occurs in certain parts of England may be seen by comparison with the numbers of osteosarcoma and fibrosarcoma cases registered at Bristol and Leeds. An overall incidence figure for Paget's sarcoma of 0·l6 and 0·18 per 100,000 population per annum has been calculated for the Bristol and Leeds areas respectively. The similarity of the age incidence curves of Paget's disease and Paget's sarcoma are shown and discussed in the light of demographic information.

2. Histologically, most Paget's sarcomata resemble recognised tumour types as seen in otherwise normal bones, the most frequent forms being osteosarcoma and fibrosarcoma. The type of tumour arising in an osteitic bone is uninfluenced by age, sex or site of origin. Thirty-eight per cent of the cases were complicated by fracture, which occurred with slightly greater frequency in fibrosarcoma and with advancing age. A causal connection between sarcoma and fracture is supported but not vice versa.

3. Survival statisticsfor this series are compared with Bristol records for osteosarcoma and fibrosarcoma (without Paget's disease), the mean survival of seventy-four patients being 11·1 months from the date of the initial symptoms of malignancy. Four long-term survivors are reported, the five-year and ten-year survival rates being respectively 5 per cent and 3·1 per cent. The effects of age, site, sex, fracture and treatment upon survival are tabulated and discussed.

1. Pain at the front of the radial side of the wrist may be caused by various lesions of the tendon and sheath of the flexor carpi radialis tendon.

2. The diagnosis may be established by testing resisted movement at the wrist and by the effect of injecting local anaesthetic into the tendon sheath.

3. In women over the age of fifty the lesion is associated with osteoarthritis of the joint between the scaphoid and the trapezium.

4. Osteoarthritis of the joint between the scaphoid and the trapezium is found in about 25 per cent of women over the age of fifty.

5. If the pain is not relieved by simple conservative measures it can usually be cured by incision of the tendon sheath.

6. The histological changes in the tendon sheath are similar to those found in tenovaginitis of the abductor pollicis longus and tibialis posterior tendons.