Diffuse Idiopathic Skeletal Hyperostosis (DISH): New evidence from micro-XCT scanning

Area of Science:

• Skeletal Biology
• Paleopathology
• Radiology

Background:

• Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a common skeletal condition characterized by excessive bone formation.
• The exact etiology and developmental processes of DISH, particularly spinal manifestations, remain incompletely understood.

Purpose of the Study:

• To investigate the microstructural development and underlying bone formation patterns of spinal lesions in individuals with DISH.
• To utilize micro-XCT imaging to gain novel insights into the pathogenesis of DISH.

Main Methods:

• Micro-focus X-ray computed tomography (micro-XCT) was employed to scan vertebral columns from 72 individuals diagnosed with DISH.
• Four key features of new bone growth were macroscopically examined: origin, cortex retention, trabecular bone presence, and abnormal osteosclerosis.

Main Results:

• Significant variation was observed in the examined features across individuals.
• 81% of individuals exhibited trabecular bone formation within new bone without retaining the original vertebral cortex.

Conclusions:

• Findings suggest localized erosive or inflammatory processes may contribute to the destruction of the vertebral cortex and subsequent bone expansion in DISH.
• Micro-XCT imaging provides new perspectives, supporting the hypothesis that DISH may have an inflammatory component.