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Degenerative changes of the thoracic spine do exist in patients with diffuse idiopathic skeletal hyperostosis: a

Einat Slonimsky1, Merav Lidar2, Myriam Stern1

  • 11 Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Affiliated with the Sackler School of Medicine, Tel Aviv University, Israel.

Acta Radiologica (Stockholm, Sweden : 1987)
|February 28, 2018
PubMed

Insights

Degenerative intervertebral disease (DID) is not an exclusion criterion for diffuse idiopathic skeletal hyperostosis (DISH) diagnosis on thoracic CT scans. Thoracic CT findings of DID should not prevent a DISH diagnosis.

Area of Science:

  • Radiology
  • Orthopedics
  • Rheumatology

Background:

  • Degenerative intervertebral disease (DID) is an exclusion criterion in radiographic classifications of diffuse idiopathic skeletal hyperostosis (DISH).
  • Previous descriptions noted DID in DISH, but systematic computed tomography (CT) analysis was lacking.

Purpose of the Study:

  • To evaluate the presence and prevalence of DID on thoracic spine CT scans in individuals diagnosed with DISH.

Main Methods:

  • Retrospective analysis of thoracic CT scans (D1-L1) in 158 participants (54 DISH, 54 Control 1, 50 Control 2).
  • Evaluated parameters included disc space height, protrusion, subchondral cysts/sclerosis, Schmorl nodes, vacuum phenomenon, and posterior elements.
  • Compared DISH patients with two age- and gender-matched control groups lacking DISH evidence.

Main Results:

  • Average intervertebral disc height was significantly lower in the DISH group compared to controls (4.55mm vs. 5.13mm/5.01mm, P < 0.001).
  • Costovertebral degenerative changes were more prevalent in DISH patients (P < 0.05).
  • Other DID changes were similarly prevalent in DISH and control groups, except for vacuum phenomenon (more prevalent in controls).

Conclusions:

  • The presence of degenerative intervertebral changes on thoracic CT does not preclude a diagnosis of DISH.
  • The Resnick and Niwayama radiographic DISH criteria require adaptation for CT-based diagnosis.

Keywords:
CTComputed tomographyDISHclassification criteriadegenerative changesdisc heightspine

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