Diffuse idiopathic skeletal hyperostosis with prominent appendicular bone proliferation in a dog

Area of Science:

• Veterinary Radiology
• Comparative Pathology
• Canine Orthopedics

Background:

• Diffuse idiopathic skeletal hyperostosis (DISH) is a progressive skeletal disease primarily affecting the spine.
• Current diagnostic criteria for DISH, focusing on vertebral fusion, may not fully capture appendicular manifestations.

Observation:

• A 5-year-old female Shih-tzu presented with atypical DISH.
• Radiographic and CT imaging revealed significant proliferative bone lesions in the appendicular skeleton with minimal spinal involvement.

Findings:

• The study identified enthesophytosis and multiple bony proliferations at ligament and tendon insertion sites on appendicular bones as key diagnostic features.
• These findings suggest a lamellar or trabecular pattern of bone growth characteristic of appendicular DISH.
• Vertebral bridging, the gold standard for spinal DISH, was less prominent, indicating limitations for appendicular cases.

Implications:

• This research expands the understanding of DISH presentation in non-human animals.
• It proposes refined diagnostic criteria for appendicular DISH, crucial for accurate diagnosis and management in veterinary medicine.
• The findings may prompt further investigation into the pathogenesis of DISH in the appendicular skeleton.