Diffuse idiopathic skeletal hyperostosis: diagnosis in a palaeopathological context.

Area of Science:

• Paleopathology
• Skeletal Biology
• Medical History

Background:

• Diffuse idiopathic skeletal hyperostosis (DISH) is clinically associated with metabolic disturbances and lifestyle factors.
• Skeletal DISH prevalence in archaeological samples can indicate socio-economic status.
• Current diagnostic methods for DISH in skeletal remains lack standardization.

Purpose of the Study:

• To compare the comparability of results from four different diagnostic methods for DISH prevalence.
• To evaluate the implications of varying diagnostic methods for palaeopathological health assessments.
• To assess the diagnostic value of extra-spinal enthesophytes in DISH diagnosis.

Main Methods:

• Applied four distinct diagnostic criteria to 240 skeletons (127 male, 113 female) from 16th-century Delft and modern Leiden samples.
• Statistically compared the estimated prevalence of DISH across the different diagnostic methods.
• Analyzed the distribution and diagnostic value of extra-spinal enthesophytes.

Main Results:

• The prevalence of DISH varied significantly based on the diagnostic criteria employed.
• Extra-spinal enthesophytes, often cited as DISH indicators, demonstrated variability and unreliability.
• No single method consistently identified DISH across the skeletal samples.

Conclusions:

• Explicitly stating and adhering to diagnostic criteria is crucial for reliable comparisons in palaeopathology and clinical studies.
• Diffuse idiopathic skeletal hyperostosis (DISH) diagnosis cannot solely rely on the presence of extra-spinal enthesophytes.
• Standardization of diagnostic methods is essential for accurate palaeopathological health assessments.