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Related Experiment Video

Updated: May 18, 2026

Standardized Histomorphometric Evaluation of Osteoarthritis in a Surgical Mouse Model

Standardized Histomorphometric Evaluation of Osteoarthritis in a Surgical Mouse Model

Published on: May 6, 2020

Developing new classification criteria for diffuse idiopathic skeletal hyperostosis: back to square one.

Reuven Mader¹, Dan Buskila, Jorrit-Jan Verlaan

¹Rheumatic Diseases Unit, Ha'Emek Medical Center, Afula, 18101, Israel. mader_r@clalit.org.il

Rheumatology (Oxford, England)

|October 2, 2012

Summary

Researchers aimed to redefine diffuse idiopathic skeletal hyperostosis (DISH) and establish a new classification for earlier diagnosis. Current consensus is limited, highlighting the need for further investigation into DISH criteria.

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Last Updated: May 18, 2026

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Published on: May 6, 2020

Area of Science:

Rheumatology
Orthopedics
Medical Classification

Background:

Diffuse idiopathic skeletal hyperostosis (DISH) is a condition requiring a revised definition and classification.
Current understanding necessitates an updated framework for earlier diagnosis.

Purpose of the Study:

To revise the definition of DISH.
To propose a classification system for DISH that reflects current knowledge.
To facilitate earlier diagnosis of DISH.

Main Methods:

A Delphi-like method involving rheumatologists and orthopedic surgeons.
Initial parameter suggestion followed by multi-round rating and discussion.
Worldwide survey of 39 specialists on 30 selected items for DISH classification criteria.

Main Results:

Perfect consensus (≥95% agreement) was achieved for 2 parameters: spinal ossification and bridging osteophytes.
Consensus (≥80% agreement) was reached for 2 additional parameters: exuberant bone formation.
Significant disagreement exists regarding extraspinal, constitutional, and metabolic manifestations for DISH classification.

Conclusions:

There is currently no agreement on including extraspinal, constitutional, or metabolic factors in a new DISH classification.
Further research is encouraged to restructure the definition and classification of DISH.
Developing a more sophisticated definition for DISH is essential.