Imaging of diffuse idiopathic skeletal hyperostosis (DISH)

Area of Science:

• Rheumatology
• Radiology
• Orthopedics

Background:

• Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by calcification and ossification of ligaments and entheses.
• It commonly affects the axial skeleton, particularly the thoracic spine, but can involve peripheral sites and joints not typically affected by osteoarthritis.
• DISH can be misdiagnosed as seronegative spondyloarthropathies or osteoarthritis due to its entheseal involvement.

Purpose of the Study:

• To illustrate the imaging findings of DISH.
• To aid in the diagnosis of DISH using the Resnick classification criteria.

Main Methods:

• Review of imaging findings in patients diagnosed with DISH.
• Application of the Resnick classification criteria for diagnosis.

Main Results:

• DISH imaging findings include calcification/ossification of ligaments and entheses.
• Involvement of the axial skeleton (especially thoracic spine) and peripheral sites.
• Potential for misdiagnosis with other arthropathies and association with other health issues.

Conclusions:

• Accurate imaging interpretation is key for DISH diagnosis.
• Understanding DISH imaging features aids in differentiating it from other conditions.
• Recognition of DISH is important due to its association with fractures, procedural difficulties, and systemic diseases.