Chest radiographs as a screening test for diffuse idiopathic skeletal hyperostosis

Area of Science:

• Radiology
• Orthopedics
• Rheumatology

Background:

• Diffuse idiopathic skeletal hyperostosis (DISH) diagnosis can be challenging.
• Current diagnostic methods may require specialized imaging.
• Evaluating non-standard imaging for DISH screening is crucial.

Purpose of the Study:

• To assess the diagnostic accuracy of chest radiographs for diffuse idiopathic skeletal hyperostosis (DISH).
• To determine the sensitivity, specificity, and reliability of chest X-rays in identifying DISH.
• To evaluate interrater and intrarater reliability of radiologists interpreting chest radiographs for DISH.

Main Methods:

• A retrospective review of thoracic spine radiographs from 151 patients (45 DISH, 106 controls).
• Two radiologists independently assessed randomized chest radiographs using a diagnostic certainty scale.
• Radiologists reassessed the same radiographs after a two-month interval to evaluate intrarater reliability.

Main Results:

• Chest radiographs demonstrated high sensitivity (77%) and specificity (97%) for DISH detection.
• Positive and negative predictive values were both 91%.
• Exceptional interrater (kappa=0.93) and intrarater (kappa=0.90-0.96) reliability was observed.

Conclusions:

• Chest radiographs serve as a reliable and valid screening tool for diagnosing diffuse idiopathic skeletal hyperostosis (DISH).
• The high accuracy and reliability support the use of chest X-rays in DISH screening protocols.