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Diffuse idiopathic skeletal hyperostosis

M Cammisa1, A De Serio, G Guglielmi

  • 1Diagnostic Imaging Department, IRCCS Casa Sollievo della Sofferenza, S. Giovanni Rotondo (FG), Italy.

European Journal of Radiology
|July 4, 1998
PubMed
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Diffuse idiopathic skeletal hyperostosis (DISH) is a common condition in the elderly, characterized by spinal ossification. Conventional radiography confirms diagnosis, while CT and MRI detect associated findings and complications.

Area of Science:

  • Rheumatology
  • Radiology
  • Orthopedics

Background:

  • Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory spinal disorder.
  • It is characterized by extensive ossification of ligaments and entheses.
  • DISH is frequently observed in elderly populations.

Purpose of the Study:

  • To detail the axial and appendicular skeletal manifestations of DISH.
  • To evaluate the diagnostic utility of radiography, CT, and MRI for DISH.
  • To discuss differential diagnoses and potential diagnostic challenges.

Main Methods:

  • Review of literature on DISH findings in vertebral and extravertebral sites.
  • Description of diagnostic criteria for spinal DISH, including ossification patterns and joint integrity.

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  • Analysis of imaging modalities for DISH diagnosis.

    • Main Results:

    • DISH affects men and women equally, predominantly in the thoracic spine.
    • Onset is typically in the sixth and seventh decades, with a 5-15% prevalence in the elderly.
    • Symptoms include back pain, stiffness, dysphagia, tendinitis, and myelopathy.

    Conclusions:

    • Conventional radiography is effective for diagnosing DISH.
    • CT and MRI offer superior detection of associated findings like ossification of the posterior longitudinal ligament.
    • Advanced imaging aids in identifying complications such as spinal cord compression.