Diffuse idiopathic skeletal hyperostosis: Imaging findings with special focus on extraspinal involvement

Area of Science:

• Rheumatology
• Orthopedics
• Radiology

Background:

• Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a prevalent, multifactorial condition often discovered incidentally.
• Diagnostic criteria primarily focus on spinal (axial) involvement, overlooking peripheral manifestations.

Purpose of the Study:

• To highlight the less-recognized peripheral involvement patterns of DISH.
• To discuss the significant complications associated with DISH, including fractures and airway obstruction.
• To emphasize the importance of identifying peripheral DISH for comprehensive patient management.

Main Methods:

• Review of diagnostic criteria for DISH.
• Analysis of imaging findings related to peripheral joint involvement.
• Correlation of peripheral DISH with clinical complications.

Main Results:

• Peripheral joint involvement in DISH is frequent, though less studied than axial disease.
• Complications include vertebral fractures from low-energy trauma and cervical issues like dysphagia and airway obstruction.
• Radiological identification of peripheral patterns aids clinical decision-making.

Conclusions:

• Peripheral involvement is a key feature of DISH that requires attention.
• Early recognition of DISH complications improves patient outcomes.
• Integrated radiological and clinical assessment is vital for managing DISH patients effectively.