Diffuse idiopathic skeletal hyperostosis (DISH): relation to vertebral fractures and bone density

Area of Science:

• Geriatric medicine
• Radiology
• Orthopedics

Background:

• Diffuse idiopathic skeletal hyperostosis (DISH) is a common condition in older adults.
• The association between DISH, vertebral fractures, and bone mineral density (BMD) requires further investigation.

Purpose of the Study:

• To determine the prevalence of DISH in men aged 65 and older.
• To evaluate the relationship between DISH, vertebral fractures, and BMD measurements using dual X-ray absorptiometry (DXA) and quantitative CT (QCT).

Main Methods:

• Analysis of spinal radiographs from 342 men (≥ 65 years) for DISH and vertebral fractures.
• Measurement of lumbar BMD using DXA and QCT.
• Statistical analysis (chi-squared and t-tests) to assess associations.

Main Results:

• DISH was present in 52% of participants.
• Men with DISH had a higher prevalence of vertebral fractures.
• DXA showed higher BMD in men with DISH, while QCT revealed lower BMD in men with both DISH and fractures, indicating potential measurement unreliability.

Conclusions:

• DISH is associated with an increased risk of vertebral fractures in elderly men.
• Paravertebral ossifications in DISH can influence BMD interpretations, necessitating careful consideration for accurate fracture risk prediction.