Type:
Educational Exhibit
Keywords:
Musculoskeletal bone, Musculoskeletal joint, Musculoskeletal system, CT, MR, Plain radiographic studies, History, Connective tissue disorders, Epidemiology
Authors:
D. HERRÁN DE LA GALA, T. Cobo Ruiz, D. Castanedo Vázquez, A. B. Barba Arce, A. Lamagrande Obregón, S. Cayón Somacarrera, R. M. Landeras Alvaro, E. C. Gallardo Agromayor
DOI:
10.26044/ecr2023/C-11169
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 of age [3,4]. It is more common in Caucasian males and the incidence increases with age [5]. Although the etiology of DISH is unknown, it has been related to multiple factors such as: diabetes mellitus, obesity, hypertension, hyperuricaemia, atherosclerosis, vitamin A preparations and genetic factors.
The most frequently involved anatomic region in DISH is the axial skeleton [6], although peripheral joints may also be involved.
Stiffness and back pain are the most frequent clinical manifestations, described in up to 84% of patients, with stiffness being the most constant [7,8]. It is believed that these symptoms may be more intense in early stages of the disease [9].
The aim of this presentation is to describe DISH’s radiological appearance (both at the axial and peripheral level), diagnostic criteria, differential diagnoses and major complications.