Related Experiment Video
Updated: Jul 28, 2026
07:32
Standardized Histomorphometric Evaluation of Osteoarthritis in a Surgical Mouse Model
Published on: May 6, 2020
Classification criteria for diffuse idiopathic skeletal hyperostosis: a lack of consensus
Jonneke S Kuperus1, Erin E A de Gendt1, F Cumhur Oner1
1Department of Orthopaedics.
Rheumatology (Oxford, England)
|April 4, 2017
Summary
Diffuse idiopathic skeletal hyperostosis (DISH) diagnosis lacks consistent criteria. This review summarizes existing DISH classification methods, highlighting the need for uniform criteria to improve research and diagnosis of this spinal ossification condition.
Area of Science:
- Rheumatology
- Orthopedics
- Radiology
Background:
- Diffuse idiopathic skeletal hyperostosis (DISH) is defined by flowing ossifications of the spine and potentially peripheral entheses.
- Current studies on DISH prevalence and pathogenesis are hampered by varied and overlapping classification criteria, limiting comparative analysis.
- A lack of standardized diagnostic criteria complicates the understanding and research of DISH.
Purpose of the Study:
- To systematically review and summarize existing classification criteria for Diffuse Idiopathic Skeletal Hyperostosis (DISH).
- To identify discrepancies and commonalities in diagnostic criteria for DISH.
- To provide a foundation for developing more uniform diagnostic and classification criteria for DISH.
Main Methods:
- A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library, and Web of Science using terms related to DISH.
- Articles proposing new classification criteria for DISH were included if independently verified by two observers.
- Methodological quality of retrieved articles was assessed, and their proposed criteria were extracted.
Main Results:
- Twenty-four articles met the inclusion criteria, all requiring spinal hyperostosis for DISH diagnosis.
- Peripheral, extraspinal manifestations were included in five criteria sets.
- Key discrepancies were noted in the number of affected vertebral bodies, definitions of developmental phases, and the progressive nature of DISH, with over half of criteria being dichotomous.
Conclusions:
- This systematic review highlights significant heterogeneity and lack of consensus in current classification criteria for Diffuse Idiopathic Skeletal Hyperostosis (DISH).
- The variability in criteria complicates the diagnosis, particularly for early-stage DISH.
- Developing consensus criteria that incorporate the progressive nature of new bone formation in DISH is feasible and recommended.
Keywords:
classification criteriadiagnostic criteriadiffuse idiopathic skeletal hyperostosisradiographysystematic reviewMore Related Videos
Related Concept Videos
01:31Osteoclasts in Bone Remodeling
Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during bone...
01:29Bone Disorders
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:28Disorders of the Skeletal Muscle
The clinical conditions affecting the skeletal muscle tissue are broadly categorized as musculoskeletal and neuromuscular disorders.
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...