Learning objectives
This exhibit will:
Describe the most frequent radiological findings of DISH in the spine.
Establish the diagnostic criteria and their usefulness in DISH differential diagnosis.
Show the most frequent extraspinal findings.
Illustrate the most frequent DISH complications.
Background
Diffuse Idiopathic Skeletal Hyperostosis (DISH), formerly known as ankylosing vertebral hyperostosis or Forestier's disease, is a disease consisting of ossification of the entheses. It was first described by Jacques Forestier and Jaume Rotés Querol in 1950 [1]. In 1976, Resnick and Niwayama coined the current term DISH and defined the first radiological diagnostic criteria [2].
DISH is an under-diagnosed disease, with a prevalence which varies from 12.8-20% of the general population over 40-50 years of age, reaching up to 40-50% in individuals over 70 years...
Findings and procedure details
DIAGNOSTIC CRITERIA
The first diagnostic criteria were described by Resnick and Niwayama [2]. These criteria consisted of the presence of continuous ossification of the right anterolateral aspect of four consecutive vertebral bodies in the absence of signs of degenerative disc disease, ankylosis or joint erosions.
In 1985, Arlet and Maziére similar criteria reducing the number of vertebral bodies affected by bony bridges to three. They also added ossification of the iliolumbar, sacroiliac and apical axis ligaments to their diagnostic criteria [11].
Utsinger et al. developed...
Conclusion
DISH is a highly prevalent and underdiagnosed disease, whose hallmark consists in skeletal involvement. Extraspinal involvement, especially in isolation, may go unnoticed. Extraspinal involvement precedes spinal radiological findings and can be found in younger patients. Knowledge of the main findings, diagnostic criteria, extraspinal involvement and possible complications of this entity are essential in our daily work.
Personal information and conflict of interest
D. Herrán De La Gala:
Nothing to disclose
T. Cobo Ruiz:
Nothing to disclose
D. Castanedo Vázquez:
Nothing to disclose
A. B. Barba Arce:
Nothing to disclose
A. Lamagrande Obregón:
Nothing to disclose
S. Cayón Somacarrera:
Nothing to disclose
R. M. Landeras Alvaro:
Nothing to disclose
E. C. Gallardo Agromayor:
Nothing to disclose
References
1. Forestier J, Rotes-Querol J. Hyperostose ankylosante vertebrale senile. Rev Rhum Mal Osteoartic. 1950;17:525–34.
Resnick D, Niwayama G. Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). Radiology. 1976;119:559–68. http://dx.doi.org/10.1148/119.3.559
Bloom RA. The Prevalence of Ankylosing Hyperostosis in a Jerusalem Population—with Description of a Method of Grading the Extent of the Disease. Scand J Rheumatol. 1984;13:181–9. http://dx.doi.org/10.3109/03009748409100384
Ciaffi J, Borlandelli E, Visani G, Facchini G, Miceli M, Ruscitti P, et al. Prevalence and characteristics of diffuse idiopathic skeletal hyperostosis (DISH) in...