A review of 290 patients with Paget's disease of bone revealed 83% had one or more rheumatic syndromes. The most common finding was back pain (37%), most often related to an independent osteoarthritic process or Paget's disease precipitating or complicating spinal osteoarthritis. Paget's disease as a sole source of back pain was distinctly uncommon (2%). Osteoarthritis related to Paget's disease was present in the hip (30%) and knee (11%). Paget's disease in spondylitis was present in 4 patients and in ankylosing hyperostosis in 4 patients. The latter group had very active Paget's disease. Rheumatoid arthritis (1%), hyperuricemia (20%), and gout (4%) did not appear increased in this group.