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Diffuse interstitial skeletal hyperostosis (DISH) in type 2 diabetes.

B Ghosh¹, S Kishore, V Vijay

¹Diabetes Research Centre and MV Hospital for Diabetes, WHO Collaborating Centre for Research, Education and Training in Diabetes, Royapuram, Chennai - 13.

The Journal of the Association of Physicians of India

|May 12, 2005

Summary

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This case report highlights a rare instance of Diffuse Idiopathic Skeletal Hyperostosis (DISH) syndrome in a type 2 diabetic patient. The diagnosis was confirmed through characteristic X-ray findings of spinal osteophytes and anterior cervical vertebral changes.

Area of Science:

Rheumatology
Endocrinology
Radiology

Background:

Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a non-inflammatory condition characterized by excessive bone formation.
DISH syndrome is often associated with metabolic conditions like type 2 diabetes mellitus.
Early diagnosis and management are crucial for preventing complications and improving patient outcomes.

Observation:

A 58-year-old female with type 2 diabetes presented with chronic backache, neck pain, and generalized weakness.
Radiological examination revealed extensive osteophytes and new bone formation in the lumbar spine.
Cervical spine X-rays demonstrated the characteristic 'melting candle-wax' appearance anterior to the vertebrae.

Findings:

The clinical presentation and radiological findings were consistent with Diffuse Idiopathic Skeletal Hyperostosis (DISH) syndrome.

Related Experiment Videos

The 'melting candle-wax' sign on cervical X-ray is a hallmark of DISH.

The co-occurrence of type 2 diabetes and DISH syndrome in this patient warrants further investigation.

Implications:

This case underscores the importance of considering DISH syndrome in patients with type 2 diabetes presenting with spinal pain.
Recognizing the characteristic radiological features can aid in early diagnosis and appropriate management.
Further research into the link between metabolic syndrome and skeletal hyperostosis may reveal new therapeutic targets.