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Diffuse idiopathic skeletal hyperostosis: differentiation from ankylosing spondylitis.

Ignazio Olivieri1, Salvatore D'Angelo, Carlo Palazzi

  • 1Rheumatology Department of Lucania, Ospedale San Carlo, Contrada Macchia Romana, Potenza 85100, Italy. ignazioolivieri@tiscalinet.it

Current Rheumatology Reports
|September 24, 2009
PubMed
Summary

Diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) can cause similar spinal mobility issues. However, distinct radiologic findings help differentiate these bone proliferation diseases.

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Area of Science:

  • Rheumatology
  • Radiology
  • Orthopedics

Background:

  • Diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) affect the axial skeleton and entheses, leading to bone proliferations.
  • Both conditions can cause spinal mobility limitations and postural abnormalities in advanced stages.
  • Radiographic differentiation can be challenging due to overlapping clinical presentations.

Purpose of the Study:

  • To review the distinct clinical and radiographic features of DISH and AS.
  • To provide guidance for accurate differential diagnosis between DISH and AS.
  • To clarify diagnostic challenges, especially in advanced disease stages.

Main Methods:

  • Review of clinical presentations of DISH and AS.
  • Analysis of characteristic radiographic findings for both conditions.

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  • Comparison of imaging features to highlight differences.

    • Main Results:

    • DISH and AS exhibit dissimilar bone proliferation patterns.
    • Distinct spinal radiographic findings allow for differentiation even in co-occurrence.
    • Clinical and radiographic features, when considered together, facilitate diagnosis.

    Conclusions:

    • Accurate differentiation between DISH and AS is achievable through careful evaluation of clinical and radiographic characteristics.
    • Awareness of specific features aids clinicians in distinguishing these two bone-related disorders.
    • Radiographic analysis is key to resolving diagnostic confusion between DISH and AS.