A survey of the 2075 cases in the Leeds Bone Tumour Registry showed that 54 cases of Primary Lymphoma of Bone that had been registered since data collection began in 1958 (2.6% of primary bone tumours). The overall sex ratio was 1.5 males: 1 female, largely due to the preponderance of males in the under 40 age group. The age distribution was bimodal, the second peak of incidence demonstrating a significant reversal of the sex ratio with females being more commonly affected in the older group. The clinical features and radiological findings were non-specific, diagnosis relying principally on tissue histology. The overall survival at five years was 46% and was not affected by the interval from the onset of symptoms until the final diagnosis.

The value of a joint registry is dependent on the accuracy and completeness of the data entered. Our registry, therefore, fails as an implant registry. We believe that compliance for data registration can only be ensured if dedicated data collection staff are employed to co-ordinate the data collection and collation process.

Polymsyalgia rheumatica 16 9 7 2 patients tested were hypothyroid. The table shows the time of onset of the hypothyroidism; in five patients it developed during follow up, after six months to 10 years. There was no significant difference in mean age, erythrocyte sedimentation rate, haemoglobin concentration, or platelet count between the hypothyroid and euthyroid patients. As expected, there were proportionately more women than men (ratio 12:3) among those with hypothyroidism. Thyroid autoantibodies were present in seven of the 11 patients screened prospectively (five with giant cell arteritis and two with polymyalgia rheumatica). CommentHypothyroidism occurred concurrently with polymyalgia rheumatica and giant cell arteritis or developed during follow up in a high proportion of patients (15/36). This has important implications for the treatment of patients in whom the rheumatic symptoms of hypothyroidism2 could be misconstrued as an exacerbation of their symptoms, resulting in unnecessary increases in the steroid dose. This happened in one of our patients: the typical symptoms of polymyalgia rheumatica responded to steroid treatment, but a year later she developed aches and pains with general malaise suggesting a relapse of the disease. At this stage her erythrocyte sedimentation rate was normal, although her mean corpuscular volume was raised. Her steroid dose was increased, but her condition did not improve. Measurement of the serum thyroxine and thyroid stimulating hormone concentrations confirmed the development of primary hypothyroidism. Her symptoms improved with thyroxine replacement. Despite remaining euthyroid she had one relapse of her polymyalgia rheumatica when her steroid dose was reduced.The association of the two conditions supports the idea of a common autoimmune aetiology. More work is needed to assess the importance, if any, of thyroid autoantibodies in euthyroid patients with polymyalgia rheumatica or giant cell arteritis.

Primary bone tumours are rare in the hand and wrist. This 34-year survey of the Leeds Regional Bone Tumour Registry reveals 80 such tumours, representing 3.9% of the total number of bone tumours in the registry. The large majority of these tumours were benign (86%), and were found predominantly in younger patients. Malignant lesions were found more frequently in older patients. 61% of tumours were found in the metacarpals and proximal phalanges. Two-thirds of patients (67.5%) presented with features of swelling, either with or without pain. We conclude that the information gathered from Bone Tumour Registries is of value in describing tumour characteristics, where such information could not be gathered by personal experience alone.

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