Frequency of first symptoms (n=226). PDB the category other combination of weakness patterns includes: distal UL symmetric W, five cases; proximal Ll asymmetric W, five cases; distal UL and Ll W, four cases; distal and proximal UL and Ll W, four cases; distal UL and proximal and distal Ll W, three cases; proximal and distal UL W, three cases; proximal UL asymmetric; W, two cases; distal UL asymmetric W, two cases and proximal UL and proximal and distal Ll W, one case. LL, lower limbs; PDB, Paget’s disease of the bone; UL, upper limbs; w, weakness.