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Journal articles on the topic 'Diffuse Idiopathic Skeletal Hyperostosis (DISH)'

Author: Grafiati

Published: 4 June 2021

Last updated: 8 February 2022

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1

Eviatar, E., and M. Harell. "Diffuse idiopathic skeletal hyperostosis with dysphagia." Journal of Laryngology & Otology 101, no. 6 (June 1987): 627–32. http://dx.doi.org/10.1017/s0022215100102403.

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AbstractDysphagia due to cervical osteophytes is not common. However, diffuse idiopathic skeletal hyperostosis (DISH) with cervical involvement which causes dysphagia is even rarer. The otolaryngologist is not generally familiar with this entity. The diagnosis can be made by plain cervical X-ray films, a barium swallowing esophagogram and or a CT scan of the neck. When doubt still exists, further extra-axial X-ray films can be helpful. Although most patients have been treated surgically, there may be a role for conservative therapy initially, as surgery in elderly DISH patients is often morbid and even fatal.A 79-year-old patient with DISH (Forestier's disease) is reported. Non-steroidal antiinflammatory therapy was successfully implemented. DISH is compared with other disorders of the cervical spine which may cause dysphagia.

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2

Apoorva V, Dr Dodia, Dr Pratik D. Shah, and Dr Soman Shardul M. "Diffuse Idiopathic Skeletal Hyperostosis (DISH) – a Rare Presentation of the Disease." Indian Journal of Applied Research 3, no. 8 (October 1, 2011): 587–89. http://dx.doi.org/10.15373/2249555x/aug2013/185.

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3

Haddad, Amir, Arane Thavaneswaran, Sergio Toloza, Vinod Chandran, and Dafna D. Gladman. "Diffuse Idiopathic Skeletal Hyperostosis in Psoriatic Arthritis." Journal of Rheumatology 40, no. 8 (June 15, 2013): 1367–73. http://dx.doi.org/10.3899/jrheum.121433.

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Objective.To determine the prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in patients with psoriatic arthritis (PsA) and to identify the features associated with its occurrence.Methods.Patients were recruited from the University of Toronto PsA observational cohort initiated in 1978. All patients fulfilled the CASPAR criteria. Radiographs of peripheral joints and spine were obtained every 2 years. DISH was defined as flowing bony bridges in at least 4 contiguous thoracic vertebrae. Each PsA patient with DISH was matched by sex to 3 PsA patients without DISH. Demographics, disease characteristics, and radiographic features were compared using McNemar test, Fisher’s exact test, chi-square test, and paired t test as appropriate. Logistic regression analyses models with stepwise regression were conducted.Results.DISH was observed in 78 (8.3%) of 938 patients with PsA. Patients with DISH were older and had longer disease duration, higher body mass index (BMI), and higher uric acid levels. Diabetes and hypertension were more prevalent in patients with DISH than in those without. The severity of radiographic damage to peripheral joints was also greater in patients with DISH. The presence of inflammatory back pain, HLA-B*27 allele, and sacroiliitis was similar in both groups. Patients with DISH had more syndesmophytes and calcaneal spurs. Older age, higher BMI, and the presence of radiographic damage to peripheral joints were associated with DISH in multivariate analysis.Conclusion.The diagnosis of DISH is possible in the presence of axial PsA. DISH was associated with known DISH-related factors including older age and high BMI, as well as the presence of radiographic damage to peripheral joints.

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4

Mader, Reuven, Xenofon Baraliakos, Iris Eshed, Irina Novofastovski, Amir Bieber, Jorrit-Jan Jorrit-Jan Verlaan, David Kiefer, Nicola Pappone, and Fabiola Atzeni. "Imaging of diffuse idiopathic skeletal hyperostosis (DISH)." RMD Open 6, no. 1 (February 2020): e001151. http://dx.doi.org/10.1136/rmdopen-2019-001151.

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Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterised by calcification and ossification of ligaments and entheses. The condition usually affects the axial skeleton, in particular, at the thoracic segment, though also other portions of the spine are often involved. DISH often involves also peripheral tendinous and/or entheseal sites either alone, or in association with the involvement of peripheral joints. At times, new bone formation involves the bone itself, but sometimes it involves joints not usually affected by osteoarthritis (OA) which result in bony enlargement of the epiphysis, joints space narrowing and a reduced range of motion. Because of the entheseal involvement, DISH can be mistaken for seronegative spondyloarthropathies or for a "simple" OA. Furthermore, other implications for the recognition of DISH include spinal fractures, difficult intubation and upper endoscopies, decreased response rates in DISH with concomitant spondyloarthritides, and increased likelihood to be affected by metabolic syndrome and cardiovascular diseases. This Atlas is intended to show the imaging finding in DISH in patients diagnosed with the condition by the Resnick classification criteria.

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5

Stechison, Michael T., and Charles H. Tator. "Cervical myelopathy in diffuse idiopathic skeletal hyperostosis." Journal of Neurosurgery 73, no. 2 (August 1990): 279–82. http://dx.doi.org/10.3171/jns.1990.73.2.0279.

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✓ The case of a rapidly progressive cervical myelopathy in a 64-year-old man is presented. Radiological studies revealed a partial extradural block, which at surgery was found to be a focal fibrous, calcified mass associated with the ligamentum flavum. On the basis of the underlying disorder of diffuse idiopathic skeletal hyperostosis (DISH), the etiology of this compression was concluded to be focal fibrous proliferation and dystrophic calcification. The neurological complications of DISH are reviewed. The authors are not aware of any other reports of this cause of myelopathy associated with DISH.

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6

Ohki, Masafumi. "Dysphagia due to Diffuse Idiopathic Skeletal Hyperostosis." Case Reports in Otolaryngology 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/123825.

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Diffuse idiopathic skeletal hyperostosis (DISH) is usually asymptomatic. However, rarely, it causes dysphagia, hoarseness, dyspnea, snoring, stridor, and laryngeal edema. Herein, we present a patient with DISH causing dysphagia. A 70-year-old man presented with a 4-month history of sore throat, dysphagia, and foreign body sensation. Flexible laryngoscopy revealed a leftward-protruding posterior wall in the hypopharynx. Computed tomography and magnetic resonance imaging revealed a bony mass pushing, anteriorly, on the posterior hypopharyngeal wall. Ossification included an osseous bridge involving 5 contiguous vertebral bodies. Dysphagia due to DISH was diagnosed. His symptoms were relieved by conservative therapy using anti-inflammatory drugs. However, if conservative therapy fails and symptoms are severe, surgical treatments must be considered.

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7

Mudiraj, Nitin R., and Manisha R. Dhobale. "Diffuse idiopathic skeletal hyperostosis - a case report." National Journal of Clinical Anatomy 02, no. 02 (April 2013): 086–88. http://dx.doi.org/10.1055/s-0039-3401704.

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AbstractThe case reported here is an incidental finding of a specimen of lower three lumbar vertebrae with sacrum. It displayed ossification of anterolateral aspect of lower three lumbar vertebrae with sparing of intervertebral disc space. Para-articular osteophytosis was found at zygopophyseal (facet) joints, however ankylosis was absent at zygopophyseal joints as well as at interspinous sites. Based on its features we labelled it as a case of diffuse idiopathic skeletal hyperostosis (DISH). It is a common but often unrecognized disorder of unknown etiology in elderly individuals. The awareness of this entity may stimulate clinicians and researchers to focus on its pathogenesis, treatment and prevention.

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8

Ohlerth, S., G. Steiner, U. Geissbühler, and M. Flückiger. "Diffuse idiopathic skeletal hyperostosis in the dog (DISH): a review." Schweiz Arch Tierheilkd 158, no. 5 (May 5, 2016): 331–39. http://dx.doi.org/10.17236/sat00061.

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9

Pillai, Sruti, and Geoffrey Littlejohn. "Metabolic Factors in Diffuse Idiopathic Skeletal Hyperostosis – A Review of Clinical Data." Open Rheumatology Journal 8, no. 1 (December 19, 2014): 116–28. http://dx.doi.org/10.2174/1874312901408010116.

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Objectives: We aimed to review the literature linking metabolic factors to Diffuse Idiopathic Skeletal Hyperostosis (DISH), in order to assess associations between growth factors and DISH. Method: We identified studies in our personal database and PubMed using the following keywords in various combinations: “diffuse idiopathic skeletal hyperostosis”, “ankylosing hyperostosis”, “Forestier’s disease”, “diabetes”, “insulin”, “obesity”, “metabolic”, “growth factors”, “adipokines”, “glucose tolerance” and “chondrocytes”. Results: We were not able to do a systematic review due to variability in methodology of studies. We found positive associations between obesity (especially abdominal obesity), Type 2 diabetes mellitus, glucose intolerance, hyperinsulinemia and DISH. Conclusion: Current research indicates that certain metabolic factors associate with DISH. More precise studies deriving from these findings on these and other newly identified bone-growth factors are needed.

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10

Jeyaraman, Madhan, Ramesh R,, and Prajwal G. S. "Diffuse idiopathic skeletal hyperostosis (DISH) – A case report." IP International Journal of Orthopaedic Rheumatology 4, no. 2 (December 15, 2018): 76–79. http://dx.doi.org/10.18231/2455-6777.2018.0018.

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11

Öğden, Mustafa, Ulas Yüksel, Suleyman Akkaya, Jonathan Oppong, Üçler Kısa, Bulent Bakar, and Mehmet Faik Ozveren. "Diffuse idiopathic skeletal hyperostosis (DISH): a clinical study." Ortadoğu Tıp Dergisi 11, no. 2 (June 1, 2019): 107–13. http://dx.doi.org/10.21601/ortadogutipdergisi.431357.

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12

Rotes-Querol, J. "Clinical manifestations of diffuse idiopathic skeletal hyperostosis (DISH)." Rheumatology 35, no. 12 (December 1, 1996): 1193–94. http://dx.doi.org/10.1093/rheumatology/35.12.1193.

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13

Pappone, N., C. Di Girolamo, A. Del Puente, R. Scarpa, and P. Oriente. "Diffuse idiopathic skeletal hyperostosis (DISH): a retrospective analysis." Clinical Rheumatology 15, no. 2 (March 1996): 121–24. http://dx.doi.org/10.1007/bf02230327.

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14

Beyeler, C., L. Lehmann, P. Schlapbach, N. J. Gerber, and W. A. Fuchs. "Diffuse idiopathic skeletal hyperostosis (DISH) of the shoulder." Rheumatology International 15, no. 3 (September 1995): 107–10. http://dx.doi.org/10.1007/bf00302126.

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15

Khairullah, Anuar, Hitam Shahrul, and Sushil Brito Mutuyanagam. "Diffuse Idiopathic Skeletal Hyperostosis: A Rare Cause of Dysphagia." Philippine Journal of Otolaryngology-Head and Neck Surgery 29, no. 2 (November 30, 2014): 34–36. http://dx.doi.org/10.32412/pjohns.v29i2.429.

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Diffuse idiopathic skeletal hyperostosis (DISH) is a disease characterized by massive, non-inflammatory ossification with intensive formation of osteophytes affecting ligaments, tendons, and fascia of the anterior part of the spinal column, mostly in the middle and lower thoracic regions. However, isolated and predominant cervical spinal involvement may occur. It has predilection for men (65%) over 50 years of age and a prevalence of approximately 15-20% in elderly patients.1 A CT scan is one of the diagnostic tools. The radiographic diagnostic criteria in the spine include: 1) osseous bridging along the anterolateral aspect of at least four vertebral bodies; 2) relative sparing of intervertebral disc heights, with minimal or absent disc degeneration; and 3) absence of apophyseal joint ankylosis and sacroiliac sclerosis.2 We present a rare case of dysphagia over 2 years duration due to DISH. Case Report A 55-year-old Malay man presented with intermittent dysphagia for 2 years duration. He denied foreign body ingestion, globus sensation or any laryngeal trauma, shortness of breath, hoarseness or any neurological deficits. A solitary smooth mass on the right posterolateral pharyngeal wall that was hard in consistency was appreciated on oropharyngeal examination. (Figure 1) There was no significant cervical lymphadenopathy and the neurological examination was unremarkable. Cervical Radiographs and CT scan showed marked ossification at the right anterolateral aspect of cervical vertebral bodies C2 to C7 most probably representing a Diffuse Idiopathic Skeletal Hyperostosis. (Figures 2, 3) He was treated conservatively with 6-monthly follow up. Discussion Diffuse Idiopathic Skeletal Hyperostosis (DISH) is an ossifying diasthesis characterized by the thickening and calcification of soft tissue (ligaments, tendons and joint capsule) resulting in secondary formation of osteophytes. Most commonly it affects the paraspinal ligaments, predominantly the anterior longitudinal ligament and occasionally the posterior longitudinal ligament.2 It was first described as senile ankylosing hyperostosis of the spine by Forestier and Rodes Querol in 1950.3 In 1970 Resnick et al. coined the term DISH for this systemic entity. Radiologically, they established 3-diagnostic criteria which include 1) Presence of flowing ossification of anterior longitudinal ligament of at least four contiguous vertebral bodies, 2) Preservation of intervertebral disc height, and 3) Absence of apophyseal joint ankylosis or sacroiliac joint erosion, sclerosis or fusion.4 Cervical anterior osteophytes accompanying DISH are mostly asymptomatic. They may present with cervical pain and stiffness. Large osteophytes however do cause dysphagia and it is the most common presenting complaint, affecting 17 – 28% of patients.5 Many different mechanisms have been suggested as the cause of the dysphagia including mass effect on the esophagus by the osteophytes and neuropathy due to recurrent laryngeal nerve impingement.5,6 According to LIn et al., in addition to distortion of laryngoesophageal anatomy and functions, osteophytes of cervical vertebrae can alter the mechanics of pharyngeal swallowing leading to secondary inflammation and edema of mucosa and soft tissue.6 Although airway symptoms in patients with DISH appear to be rare, clinicians should be aware of this condition and its potential for acute respiratory complications. The etiology of DISH is still unclear, however according to Calisanellerr et al. it may be associated with excessive mechanical stress, hyperlipidaemia, increased levels of insulin with or without diabetes mellitus, increased levels of insulin-like growth factor-1 and hyperuricaemia.7 A positive HLA–B8 has also been reported, and hypervascularity may also play a role in the etiopathogenesis of DISH.7,8,9 Differential diagnosis of DISH includes ankylosing spondylitis, spondylosis deformans, osteoarthritis and esophageal malignancies where it should be considered when the dysphagia cannot be explained by small anterior osteophytes.5 Treatment can be divided into conservative treatment with dietary modification, swallowing therapy sessions and analgesia for early stages of mild dysphagia. Chiropractic treatment and acupuncture are popular alternatives among patients. The benefit of chiropractic therapy may lie in its role in increasing range of movement of the spine and providing pain relief.10 When conservative treatment fails, surgical interventions such as osteophytectomy, tracheotomy and feeding tube insertion are indicted. Surgical excision via perioral transpharyngeal route for C1 and C2 vertebrae or anterior cervical approach for C3 to C7 vertebrae is preferred.6,11 The aim of the surgery is to provide satisfactory decompression of the esophagus.6 Recent studies have shown that patients treated surgically with osteophytectomy had marked improvement, if not complete resolution, of their upper aerodigestive disturbances.11 It should be remembered that surgical interventions harbor the risk of recurrent laryngeal nerve injury, Horner’s syndrome, cervical instability, persistent symptoms, and recurrence.11 Dysphagia caused by diffuse idiopathic skeletal hyperostosis is an uncommon entity. Radiological evaluation specifically CT scans are diagnostic and can rule out other possible causes of oropharygeal mass. Surgical decompression may relieve the dysphagia when conservative treatments fail.

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Burger, M., K. Amort, L. Brunnberg, and M. Kornmayer. "Spinal fracture in a dog with diffuse idiopathic skeletal hyperostosis." Veterinary and Comparative Orthopaedics and Traumatology 26, no. 01 (2013): 76–81. http://dx.doi.org/10.3415/vcot-12-03-0036.

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SummaryA six-year-old, spayed female Weimaraner dog was first presented with the complaint of hindlimb paresis and then hindlimb paralysis two years later after colliding with a tree. Radiographs and computed tomography revealed spinal fractures at lumbar vertebrae (L)2-3 and at L4-5. In addition, the spinal column was affected by new bone formation along the vertebral bodies, bridging the disc spaces, as seen in diffuse idiopathic skeletal hyperostosis (DISH). Open reduction and internal fixation was achieved with standard vertebral body plating. This is the first report of DISH-associated spinal fractures after minor trauma in a dog. Surgery resulted in return of the full function after the first, and in improvement of neurologic function after the second incident.

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17

Mithani, Karim, Ying Meng, David Pinilla, Nova Thani, Kayee Tung, Richard Leung, and Howard J. Ginsberg. "Diffuse idiopathic skeletal hyperostosis masquerading as asthma: case report." Journal of Neurosurgery: Spine 31, no. 2 (August 2019): 261–64. http://dx.doi.org/10.3171/2019.2.spine181291.

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A 52-year-old man with a 10-year history of treatment-resistant asthma presented with repeated exacerbations over the course of 10 months. His symptoms were not responsive to salbutamol or inhaled corticosteroid agents, and he developed avascular necrosis of his left hip as a result of prolonged steroid therapy. Physical examination and radiography revealed signs consistent with diffuse idiopathic skeletal hyperostosis (DISH), including a C7–T1 osteophyte causing severe tracheal compression. The patient underwent C6–T1 anterior discectomy and fusion, and the compressive osteophyte was removed, which completely resolved his “asthma.” Postoperative pulmonary function tests showed normalization of his FEV1/FVC ratio, and there was no airway reactivity on methacholine challenge. DISH is a systemic, noninflammatory condition characterized by ossification of spinal entheses, and it can present with respiratory disturbances due to airway compression by anterior cervical osteophytes. The authors present, to the best of their knowledge, the first documented case of asthma as a presentation of DISH.

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18

GARG, Shriram, Sanjiv KAPOOR, and Anand Narayan MALAVIYA. "Diffuse idiopathic skeletal hyperostosis (DISH): an often missed diagnosis." International Journal of Rheumatic Diseases 11, no. 1 (April 2008): 66–68. http://dx.doi.org/10.1111/j.1756-185x.2008.00333.x.

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19

Castellano, Dominic M., John T. Sinacori, and Daniel W. Karakla. "Stridor and Dysphagia in Diffuse Idiopathic Skeletal Hyperostosis (DISH)." Laryngoscope 116, no. 2 (February 2006): 341–44. http://dx.doi.org/10.1097/01.mlg.0000197936.48414.fa.

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20

Gour-Provençal, Gabrielle, Nicholas M. Newman, Mathieu Boudier-Revéret, and Min Cheol Chang. "Severe acitretin-induced diffuse idiopathic skeletal hyperostosis: a case report." Journal of International Medical Research 48, no. 10 (October 2020): 030006052096689. http://dx.doi.org/10.1177/0300060520966896.

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Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier–Rotes–Querol disease, is a systemic noninflammatory disease characterized by ossification of the entheses. DISH predominantly affects the spine. Although peripheral involvement is also often reported, it rarely affects patients’ function. A 77-year-old man presented to our emergency department because of incapacitating pain and stiffness in the spine and hips. The patient had been diagnosed with biopsy-proven mycosis fungoides 3 years earlier and had been treated with oral acitretin at 25 to 50 mg daily since diagnosis. However, the patient gradually developed a severely limited range of motion in his spine and hips (left > right), significantly impairing his mobility and activities of daily living. Cervical and dorsolumbar radiographs showed extensive ossification along the anterior longitudinal ligament; this finding was compatible with DISH and had not been present in radiographs taken 3 years earlier. Pelvic radiographs showed multiple enthesophytes predominantly around the coxofemoral joints. DISH has been reported as a possible long-term adverse effect of acitretin. Despite optimal conservative treatment, the patient remained severely impaired and thus finally underwent extensive osteophyte excision and total hip replacement on the left side. His acitretin therapy was also stopped to prevent further progression of his DISH.

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21

Krishnarasa, Balakumar, Abhirami Vivekanandarajah, Lucinda Ripoll, Edwin Chang, and Robert Wetz. "Diffuse Idiopathic Skeletal Hyperostosis (DISH)—A Rare Etiology of Dysphagia." Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders 4 (January 2011): CMAMD.S6949. http://dx.doi.org/10.4137/cmamd.s6949.

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A 72-year-old gentleman presented to the hospital with progressively worsening dysphagia to soft foods and liquids. He was diagnosed with severe pharyngeal dysphagia by modified barium swallow. A CT scan of the neck with IV contrast showed anterior flowing of bridging osteophytes from C3-C6, indicative of DISH, resulting in esophageal impingement. He underwent resection of the DISH segments. Following the surgery, a PEG tube for nutrition supplementation was placed. However, the PEG tube was removed after five months when the speech and swallow evaluation showed no residual dysphagia. DISH is a rare non-inflammatory condition that results in pathological ossification and calcification of the anterolateral spinal ligaments.

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Toyoda, Hiromitsu, Hidetomi Terai, Kentaro Yamada, Akinobu Suzuki, Sho Dohzono, Tomiya Matsumoto, and Hiroaki Nakamura. "Prevalence of Diffuse Idiopathic Skeletal Hyperostosis in Patients with Spinal Disorders." Asian Spine Journal 11, no. 1 (February 28, 2017): 63–70. http://dx.doi.org/10.4184/asj.2017.11.1.63.

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<sec><title>Study Design</title><p>Retrospective cohort study.</p></sec><sec><title>Purpose</title><p>The purpose of this study was to evaluate the prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in patients with spinal diseases determined by roentgen images of the whole spine.</p></sec><sec><title>Overview of Literature</title><p>Although several studies have investigated the prevalence of DISH in healthy subjects, no detailed data have been reported on the prevalence of DISH in patients with degenerative spinal disorders.</p></sec><sec><title>Methods</title><p>Standing whole-spine roentgen images of 345 consecutive patients who underwent surgery in our hospital were obtained. Patients aged <18 years or with congenital spinal disease, metastatic spinal tumors, or inflammatory spinal disease were excluded. In total, 281 patients were eligible for inclusion. The presence of DISH was assessed according to Resnick's criteria and Mata's scoring system. The prevalence, location, and numbers of fused vertebral bodies of DISH were recorded.</p></sec><sec><title>Results</title><p>DISH was present in 25.6% of patients (72/281). The prevalence of DISH in the 41–49, 50–59, 60–69, 70–79, and ≥80 year age groups was 8.3% (2/24), 9.8% (5/51), 16.0% (12/75), 49.5% (48/97), and 33.3% (4/12), respectively; the prevalence increased with age. The average number of fused vertebral bodies was 7.5. More than 80% of DISH was located from T7 to T11, and more than 95% of DISH was located at T9/10. Patients with DISH were significantly older (71.1 years vs. 60.9 years, <italic>p</italic><0.05), and men were more likely to have DISH than women (<italic>p</italic><0.05).</p></sec><sec><title>Conclusions</title><p>In patients with degenerative spinal diseases with DISH, fused vertebrae were found most frequently in the lower thoracic spine, and their prevalence increased with age. DISH may be an age-related skeletal disorder with a higher overall prevalence in patients with spinal disorders than that in healthy subjects.</p></sec>

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Culvenor, J., C. Bailey, S. Davies, and A. Lai. "Femoral nerve entrapment in a dog with diffuse idiopathic skeletal hyperostosis." Veterinary and Comparative Orthopaedics and Traumatology 28, no. 02 (2015): 151–54. http://dx.doi.org/10.3415/vcot-14-09-0139.

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SummaryObjective: To report femoral neuropathy caused by nerve entrapment associated with diffuse idiopathic skeletal hyperostosis (DISH).Study Design: Case report.Animal: Seven-year-old female spayed Boxer dog.Results: Entrapment of the right femoral nerve due to DISH caused a femoral nerve deficit and atrophy of muscle groups associated with the affected nerve. A combination of computed tomography and magnetic resonance imaging was performed to provide a diagnosis. Amputation of the right transverse process of the sixth lumbar vertebra at the level of nerve entrapment relieved the neurological abnormality.Conclusions: Nerve entrapment leading to neurapraxia may occur concurrently with DISH and surgery in this case was successful in restoring function.Clinical relevance: Peripheral neuropathy from nerve entrapment should be considered in patients with DISH. Surgical amputation of impinging osseous structures may be indicated for relief of femoral neuropathy.

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Kritzer, Randy O., and Janies E. Rose. "Diffuse Idiopathic Skeletal Hyperostosis Presenting with Thoracic Outlet Syndrome and Dysphagia." Neurosurgery 22, no. 6P1-P2 (June 1, 1988): 1071–74. http://dx.doi.org/10.1227/00006123-198806010-00017.

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Abstract A case of diffuse idiopathic skeletal hyperostosis (DISH) presenting with thoracic outlet syndrome and dysphagia is reported. Although extraspinal manifestations have been reported in these patients, thoracic outlet syndrome, particularly the anatomical anomaly found at operation, is previously unreported in patients with DISH. In addition to discussing DISH and thoracic outlet syndrome, we readvocate the anterior approach for 1st rib resection that was introduced in 1967 by Gol and associates. The direct visualization offered by this approach allowed us to avoid a potential injury to the brachial plexus that may have occurred had the transaxillary approach been used.

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25

Tudor, Niculae. "A Retrospective Radiographic Study Regarding Diffuse Idiopathic Skeletal Hyperostosis (Dish) in Dogs." “Agriculture for Life, Life for Agriculture” Conference Proceedings 1, no. 1 (July 1, 2018): 490–94. http://dx.doi.org/10.2478/alife-2018-0077.

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Abstract Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic non-inflammatory disease of unknown aetiology affecting the axial and appendicular skeleton. The disease is characterised by calcification of soft tissues including tendons, joint capsules, and ligamentous attachments to bone. A retrospective radiographic study was conducted to investigate the presence and distribution of the DISH in dogs. For this goal were revised medical records from the radiology service of Faculty of Veterinary Medicine Bucharest for dogs that had a radiographic report that described the presence of DISH at spine level. The signalments of all dogs were taken from their medical records. From 531 dogs of 19 breeds, 11 dogs (Cross breed = 3; Rottweiler = 3; Boxer = 2; Golden retriever = 2; German shepherd = 1) were diagnosed with DISH, representing 2.07%. Of these, 5 were females and 6 males, aged between 6 and 15 years (an average of 9.81 years). Following the radiographic evaluation, a total of 74 vertebral segments affected by DISH were identified, and the number of vertebral segments affected per dogs varied between 4 and 10. In all cases, the DISH was accompanied by spondylosis deformans. Although the presence of flowing calcification in the ventral aspects of adjacent vertebral bodies is conclusive for classification as DISH, however it is recommended obtaining supplementation data through modern imaging exams on the vertebral structures.

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26

Patatoukas, D., H. Moumtzi, D. Zacharis, H. Solidaki, A. Koutsakis, I. Sioutis, and G. Mellos. "Diffuse idiopathic skeletal hyperostosis (DISH) causes autonomic dysreflexia in SCI." Annals of Physical and Rehabilitation Medicine 57 (May 2014): e235. http://dx.doi.org/10.1016/j.rehab.2014.03.862.

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27

Bateman, Mathew, Kamal Hapuarachchi, Clinton Pinto, and Anthony James Doyle. "Diffuse idiopathic skeletal hyperostosis (DISH): Increased prevalence in Pacific Islanders." Journal of Medical Imaging and Radiation Oncology 62, no. 2 (October 11, 2017): 188–93. http://dx.doi.org/10.1111/1754-9485.12679.

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28

Gross, N. "Dysphagia in diffuse idiopathic skeletal hyperostosis (DISH): a surgical disease?" Otolaryngology - Head and Neck Surgery 129, no. 2 (August 2003): P241. http://dx.doi.org/10.1016/s0194-5998(03)01002-7.

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29

MADER, REUVEN, IRINA NOVOFASTOVSKI, EHUD ROSNER, MUHAMMAD ADAWI, PAULA HERER, and DAN BUSKILA. "Nonarticular Tenderness and Functional Status in Patients with Diffuse Idiopathic Skeletal Hyperostosis." Journal of Rheumatology 37, no. 9 (June 15, 2010): 1911–16. http://dx.doi.org/10.3899/jrheum.091008.

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Objective.To investigate the degree of nonarticular tenderness and functional status in patients with diffuse idiopathic skeletal hyperostosis (DISH). We assessed these variables’ correlation with their clinical, radiographic, and constitutional measurements and with metabolic syndrome (MS).Methods.Eighty-seven patients with DISH were compared with 65 controls without DISH. Examination of nonarticular tenderness was performed by thumb palpation. Tenderness was scored for the 18 fibromyalgia tender points (TP), and 4 control points. Nonarticular tenderness was expressed by the number of TP and by the total tenderness score (TTS). The Short Health Assessment Questionnaire (HAQ II) was administered to all participants. Clinical and laboratory data were collected from all patients. Patients were classified as having MS by both the National Cholesterol Education Program and World Health Organization definitions.Results.There was a statistically significant difference in TTS between controls and patients with DISH. The mean tenderness of many individual TP was significantly higher in the DISH group compared with the control group. TP counts, TTS, and body mass index (BMI) positively correlated with the HAQ II. There was a linear trend in intensity of T-spine bony bridges (BB) and the total number of TP as well as many individual TP. Patients with DISH were more likely to be affected by MS. No correlation was found between TP count, TTS, and MS.Conclusion.Patients with DISH have a lower pain threshold than patients who do not have DISH. TP count and TTS correlate with the functional status, BMI, waist circumference, and high-grade BB. No correlation was observed between pain threshold and MS.

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Akhtar, S., P. E. O’Flynn, A. Kelly, and P. M. W. Valentine. "The management of dysphasia in skeletal hyperostosis." Journal of Laryngology & Otology 114, no. 2 (February 2000): 154–57. http://dx.doi.org/10.1258/0022215001904950.

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Diffuse idiopathic skeletal hyperostosis (DISH), or Forestier’s disease, is an ossifying condition frequently encountered in otolaryngology as it affects 12–28 per cent of the adult population. This form of hyperostosis can manifest clinically with dysphagia, food impaction, hoarseness, stridor, myelopathies and other neurological problems. Judicious management of severe dysphagia proves challenging. The failure of conservative care often leaves surgery as the only option. In this report an anterolateral transcervical surgical approach to the confluent osteophytes is discussed and the value of videofluoroscopic swallow highlighted

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Uehara, M., J. Takahashi, S. Ikegami, S. Kuraishi, D. Fukui, H. Imamura, K. Okada, and H. Kato. "Thoracic aortic aneurysm is an independent factor associated with diffuse idiopathic skeletal hyperostosis." Bone & Joint Journal 100-B, no. 5 (May 2018): 617–21. http://dx.doi.org/10.1302/0301-620x.100b5.bjj-2017-1298.r1.

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Aims Although we often encounter patients with an aortic aneurysm who also have diffuse idiopathic skeletal hyperostosis (DISH), there are no reports to date of an association between these two conditions and the pathogenesis of DISH remains unknown. This study therefore evaluated the prevalence of DISH in patients with a thoracic aortic aneurysm (AA). Patients and Methods The medical records of 298 patients who underwent CT scans for a diagnosis of an AA or following high-energy trauma were retrospectively examined. A total of 204 patients underwent surgery for an AA and 94 had a high-energy injury and formed the non-AA group. The prevalence of DISH was assessed on CT scans of the chest and abdomen and the relationship between DISH and AA by comparison between the AA and non-AA groups. Results The prevalence of DISH in the AA group (114/204; 55.9%) was higher than that in the non-AA group (31/94; 33.0%). On multivariate analysis, the factors of AA, male gender, and ageing were independent predictors of the existence of DISH, with odds ratios of 2.9, 1.9, and 1.03, respectively. Conclusion This study revealed that the prevalence of DISH is higher in patients with an AA than in those without an AA, and that the presence of an AA significantly influenced the prevalence of DISH. Cite this article: Bone Joint J 2018;100-B:617–21.

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Dąbrowski, Mikołaj, and Łukasz Kubaszewski. "Diffuse Idiopathic Skeletal Hyperostosis of Cervical Spine with Dysphagia—Molecular and Clinical Aspects." International Journal of Molecular Sciences 22, no. 8 (April 20, 2021): 4255. http://dx.doi.org/10.3390/ijms22084255.

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Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by the calcification and ossification of the ligaments of the cervical spine; in some cases, it may result in dysphagia. The condition is more common in men over 50 years of age with metabolic disorders, and it is often asymptomatic and not a major issue for patients. The etiology of DISH is poorly understood, and known genetic factors indicate multiple signal pathways and multigene inheritance. In this review, we discuss the epidemiological, clinical, and etiological aspects of DISH with a special focus on dysphagia.

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Clavaguera, Teresa, Patrícia Reyner, Maria Buxó, Marta Valls, Eulàlia Armengol, and Xavier Juanola. "Identifying Clinicoradiological Phenotypes in Diffuse Idiopathic Skeletal Hyperostosis: A Cross-Sectional Study." Medicina 57, no. 10 (September 24, 2021): 1005. http://dx.doi.org/10.3390/medicina57101005.

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Background and objectives: Diffuse idiopathic skeletal hyperostosis (DISH) is a bone formation disease in which only skeletal signs are considered in classification criteria. The aim of the study was to describe different phenotypes in DISH patients based on clinicoradiological features. Materials and Methods: We evaluated 97 patients who met the Resnick or modified Utsinger classification criteria for DISH and were diagnosed at our hospital from 2004 to 2015. Patients were stratified into: (a) peripheral pattern (PP)—Resnick criteria not met but presenting ≥3 peripheral enthesopathies; (b) axial pattern (AP)—Resnick criteria met but <3 enthesopathies; and (c) mixed pattern (MP)—Resnick criteria met with ≥3 enthesopathies. Statistical analysis was carried out to identify variables that might predict classification in a given group. Results: Fifty-six of the 97 patients included (57.7%) were male and 72.2% fulfilled the Resnick criteria. Applying our classification, 39.7% were stratified as MP, 30.9% as AP and 29.4% as PP. Clinical enthesopathy was reported in 40.2% of patients during the course of the disease. Sixty-eight patients were included in a comparative analysis of variables between DISH patterns. The results showed a predominance of women (p < 0.004), early onset (p < 0.03), hip involvement (p < 0.003) and enthesitis (p < 0.001) as hallmarks of PP. Asymptomatic patients were most frequently observed in AP (28.6%, MP 3.8%, PP 5.0%) while MP was characterized by a more extensive disease. Conclusions: We believe DISH has distinct phenotypes and describe a PP phenotype that is not usually considered. Extravertebral manifestations should be included in the new classification criteria in order to cover the entire spectrum of the disease.

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Bustos, Felipe A., Felipe A. Capdeville, Daniel A. Rappoport, Luis F. Zanolli, Fabio Valdes, Hugo E. Rojas, Jose M. Contreras, Giancarlo Schiappacasse, and Arturo J. Madrid. "Diffuse idiopathic skeletal hyperostosis: an uncommon complication in head and neck surgery." International Journal of Otorhinolaryngology and Head and Neck Surgery 7, no. 3 (February 24, 2021): 533. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20210691.

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<p>Diffuse idiopathic skeletal hyperostosis (DISH) is a degenerative disorder of unknown etiology that most often occurs in male patients over 50. Dysphagia is its main symptom, but they can also have dyspnea, otalgia, cough, sore throat, foreign body sensation in the pharynx, sleep apnea and glottic alterations. We present a case report and review the literature about this entity. We report a case of an oral squamous cell carcinoma that received a commando surgery and tracheostomy tube. Decanulations attempts were unsuccessful initially due to DISH. Conservative management was successful and complete rehabilitation performed, achieving decannulation 18 months after surgery. DISH can be a source of many different symptoms that may appear or be exacerbated after any surgery, and produce a postoperative complication. Conservative management is usually the best treatment, leaving surgical interventions for severe symptomatic patients. The knowledge of this entity and a high level of suspicion are very important for a proper diagnosis and management.</p>

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Sarzi-Puttini, Piercarlo, and Fabiola Atzeni. "New developments in our understanding of DISH (diffuse idiopathic skeletal hyperostosis)." Current Opinion in Rheumatology 16, no. 3 (May 2004): 287–92. http://dx.doi.org/10.1097/00002281-200405000-00021.

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Mader, Reuven, I. Novofastovski, N. Schwartz, and E. Rosner. "Serum adiponectin levels in patients with diffuse idiopathic skeletal hyperostosis (DISH)." Clinical Rheumatology 37, no. 10 (August 18, 2018): 2839–45. http://dx.doi.org/10.1007/s10067-018-4258-0.

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Fuentes-Sánchez, Daniel, Diego López-Onaindia, Rosa Dinarès, and M. Eulàlia Subirà. "Presence of the Diffuse Idiopathic Skeletal Hyperostosis in Avinganya rural population (Lleida, Iberian Peninsula)." NEXUS: The Canadian Student Journal of Anthropology 24, no. 1 (December 5, 2016): 1–12. http://dx.doi.org/10.15173/nexus.v24i1.1095.

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Diffuse idiopathic skeletal hyperostosis (DISH) has largely been associated with high socioeconomic status rather than lower social status in paleopathological studies. This difference has been explained as a consequence of a high intake of fats and sedentary lifestyle that could be related to metabolic syndrome and obesity, associated risk factors in DISH by some clinical authors. This association is also known as the ‘monastic way of life’. In this work, we present a DISH case corresponding to a male individual exhumed from a civil burial site of the necropolis of the Trinitarian Monastery of Avinganya, in the North-East of Iberian Peninsula. In this case, DISH coexists with some evidences of occupational stress markers (back lesions and traumas) that indicate a non-sedentary lifestyle, despite the individuals overweight. Therefore, the present case of DISH seems to contradict the ‘monastic way of life’ association. The previous relationship can be explained as a bias in the sample analysed, where high status individuals have longer survival ratios, so more probabilities to develop DISH, because age is a proved risk factor. In this way, mechanical stress is proposed as another risk factor of DISH, which is more accurate to explain this case.

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Darakjian, Ara, Ani B. Darakjian, Edward T. Chang, and Macario Camacho. "Refractory Obstructive Sleep Apnea in a Patient with Diffuse Idiopathic Skeletal Hyperostosis." Case Reports in Otolaryngology 2016 (2016): 1–3. http://dx.doi.org/10.1155/2016/4906863.

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Diffuse Idiopathic Skeletal Hyperostosis (DISH) can cause ossification of ligaments and may affect the spine. We report a case of obstructive sleep apnea in a patient with significant upper airway narrowing secondary to cervical DISH. This patient had an initial apnea-hypopnea index (AHI) of 145 events/hour and was treated with uvulopalatopharyngoplasty, genial tubercle advancement, hyoid suspension, septoplasty, inferior turbinoplasties, and radiofrequency ablations to the tongue base which reduced his AHI to 40 events/hour. He redeveloped symptoms, was started on positive airway pressure (PAP) therapy, and later underwent a maxillomandibular advancement which improved his AHI to 16.3 events/hour. A few years later his AHI was 100.4 events/hour. His disease has gradually progressed over time and he was restarted on PAP therapy. Despite PAP titration, years of using PAP therapy, and being 100 percent compliant for the past three months (average daily use of 7.6 hours/night), he has an AHI of 5.1 events/hour and has persistent hypersomnia with an Epworth Sleep Scale questionnaire score of 18/24. At this time he is pending further hypersomnia work-up. DISH patients require prolonged follow-up to monitor the progression of disease, and they may require unconventional measures for adequate treatment of obstructive sleep apnea.

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Goico-Alburquerque, Ana, Beenish Zulfiqar, Ranae Antoine, and Mohammed Samee. "Diffuse Idiopathic Skeletal Hyperostosis: Persistent Sore Throat and Dysphagia in an Elderly Smoker Male." Case Reports in Medicine 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/2567672.

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Diffuse idiopathic skeletal hyperostosis (DISH) is rarely symptomatic. However, it can present with dyspnea, hoarseness, dysphagia, and stridor. An 80-year-old chronic smoker male presented with 6-month history of sore throat and progressive dysphagia. Computed tomography of the neck revealed bulky anterior bridging syndesmophytes along the anterior aspect of the cervical spine and facet effusion involving four contiguous vertebrae consistent with DISH. Dysphagia secondary to DISH was diagnosed. Fiberoptic laryngoscopy showed bilateral vocal cord paralysis. Patient’s airway became compromised requiring tracheostomy tube placement. After discussion of therapeutic options, patient agreed on a percutaneous endoscopic gastrostomy tube insertion for nutritional support. Osteophytectomy was left to be discussed further.

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Nishida, Norihiro, Fei Jiang, Junji Ohgi, Masahiro Fuchida, Rei Kitazumi, Yuto Yamamura, Rui Tome, et al. "Biomechanical Analysis of the Spine in Diffuse Idiopathic Skeletal Hyperostosis: Finite Element Analysis." Applied Sciences 11, no. 19 (September 25, 2021): 8944. http://dx.doi.org/10.3390/app11198944.

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Patients with diffuse idiopathic skeletal hyperostosis (DISH) develop fractures of the vertebral bodies, even in minor trauma, because of the loss of flexibility, which causes difficulties in fusing vertebrae; therefore, the diagnosis of spine injuries may be delayed. We used the three-dimensional finite element method to add data on ossification to the healthy vertebral model in order to investigate how stress in intervertebral discs changes with bone shape and whether these changes present any risk factors. A healthy spine model and a DISH flat model (T8–sacrum) were generated from medical images. As an ossified hypertrophic model, T11–T12 was cross-linked with hypertrophic ossification, and hypertrophy was found to be 5 and 10 mm. An ossifying hypertrophic groove model (5 and 10 mm) was created at T11–T12 and T11–L1. A groove was created at the center of T12, and the radius of curvature of the groove was set to 1 and 2.5 mm. An extension force and flexion force were applied to the upper part of T8, assuming that external forces in the direction of flexion and extension were applied to the spine. Stresses were greater in the DISH flat model than in the healthy model. In the hypertrophic ossification model, the stress on the vertebral body was similar to greater ossification in extension and flexion. In the ossified hypertrophic groove model, the stress at the center of the groove increased. In DISH, vertebrae are more susceptible to stress. Furthermore, depending on the morphology of ossification, stresses on the vertebrae and intervertebral discs differed even with similar loads. An examination of ossification geometry may help surgeons decide the thoracolumbar spine’s stress elevated position in patients with DISH, thereby contributing to the understanding of the pathogenesis of pain.

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Sauvageau, Anny, Célia Kremer, and Stéphanie Racette. "Traumatic heart perforation by a D5 osteophyte." Medicine, Science and the Law 47, no. 4 (October 2007): 350–52. http://dx.doi.org/10.1258/rsmmsl.47.4.350.

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Osteophytes are bony outgrowths usually found in the context of osteoarthritis and diffuse idiopathic skeletal hyperostosis (DISH). Even if they are usually asymptomatic, they may present with complications such as spinal stenosis, myelopathy and radiculopathy. We here present the case of a 56-year-old woman found dead from a homicidal traumatic heart perforation by a D5 osteophyte.

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Kuperus, Jonneke S., Constantinus F. Buckens, Jurica Šprem, F. Cumhur Oner, Pim A. de Jong, and Jorrit-Jan Verlaan. "The Natural Course of Diffuse Idiopathic Skeletal Hyperostosis in the Thoracic Spine of Adult Males." Journal of Rheumatology 45, no. 8 (April 15, 2018): 1116–23. http://dx.doi.org/10.3899/jrheum.171091.

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Objective.Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by flowing bony bridges on the right side of the spine. Knowledge of the development of these spinal bridges is limited. The current longitudinal computed tomography (CT) study was designed to bridge this gap.Methods.Chest CT scans from elderly males with 2 scans (interval ≥ 2.5 yrs) were retrospectively included. Using the Resnick criteria, a pre-DISH group and a definite DISH group were identified. A scoring system based on the completeness of a bone bridge (score 0–3), extent of fluency, and location of the new bone was created to evaluate the progression of bone formation.Results.In total, 145 of 1367 subjects were allocated to the DISH groups with a mean followup period of 5 years. Overall prevalence of a complete bone bridge increased in the pre-DISH group (11.3% to 31.0%) and in the definite DISH group (45.0% to 55.8%). The mean bridge score increased significantly in both the pre-DISH and definite DISH group (p < 0.001). The new bone gradually became more flowing and expanded circumferentially.Conclusion.Over the mean course of 5 years, the new bone developed from incomplete, pointy bone bridges to more flowing complete bridges. This suggests an ongoing and measurable bone-forming process that continues to progress, also in established cases of DISH.

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Hamasaki, Toshiaki, Ryoko Nagai, Ryuta Murai, Hidehiko Yamamoto, and Takao Chishiro. "A case of diffuse idiopathic skeletal hyperostosis (DISH) found after cardiopulmonary resuscitation." Nihon Kyukyu Igakukai Zasshi 22, no. 10 (2011): 810–14. http://dx.doi.org/10.3893/jjaam.22.810.

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Nishimura, Yukiko, Tokurou Mochizuki, Kiyoshi Negoro, Hiroshi Nogaki, and Mitsunori Morimatsu. "A Case of Diffuse Idiopathic Skeletal Hyperostosis(DISH) with Various Neurological Complications." Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 33, no. 3 (1996): 186–90. http://dx.doi.org/10.3143/geriatrics.33.186.

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Rahimizadeh, Abolfazl, Housain Soufiani, Shaghayegh Rahimizadeh, and Mahan Amirzadeh. "Two Cases Report of Dysphagia Due to Diffuse Idiopathic Skeletal Hyperostosis (DISH)." Orthopedics Research and Traumatology – Open Journal 3, no. 1 (December 30, 2018): 26–32. http://dx.doi.org/10.17140/ortoj-3-113.

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Diederichs, G., F. Engelken, L. M. Marshall, K. Peters, D. M. Black, A. S. Issever, E. Barrett-Connor, E. Orwoll, B. Hamm, and T. M. Link. "Diffuse idiopathic skeletal hyperostosis (DISH): relation to vertebral fractures and bone density." Osteoporosis International 22, no. 6 (September 30, 2010): 1789–97. http://dx.doi.org/10.1007/s00198-010-1409-9.

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Fahrer, H., R. Barandun, N. J. Gerber, N. F. Friederich, B. Burkhardt, and M. H. Weisman. "Pelvic manifestations of diffuse idiopathic skeletal hyperostosis (DISH): are they clinically relevant?" Rheumatology International 8, no. 6 (March 1989): 257–61. http://dx.doi.org/10.1007/bf00270981.

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Clavaguera, T., E. Armengol, M. Buxó, M. Valls, E. DE Cendra, and P. Reyner. "THU0489 HIP INVOLVEMENT IN DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS (DISH): CROSS-SECTIONAL STUDY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 482.1–482. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2590.

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Background:In DISH or Forestier-Rotés disease, hip involvement is often misdiagnosed as hip osteoarthritis, especially when it is the initial manifestation of the disease or in patients with scarce vertebral signs. At present, a correct identification of this entity may suppose considerable therapeutic implications1.Objectives:The purpose of this study was to assess the prevalence and characteristics of hip involvement in our cohort of patients with DISH and evaluate the association of this extra-spinal manifestation with the variables studied.Methods:We carried out a cross-sectional study in DISH patients who met Resnick and / or Utsinger classification criteria. We collected demographic, anthropometric, clinical and imaging data. Hip involvement was defined as the characteristic irregular bony excrescences above acetabulum. The cohort was divided between patients with and without hip involvement. A univariate descriptive analysis was performed with means and standard deviations, absolute frequencies and percentages. The normality of the data was checked using the Shapiro-Willis test. The bivariate analysis, for the qualitative variables, the χ2test or Fisher’s exact test were identified. For the quantitative variables, the Student’s t-test was used if the data followed a normal distribution, and otherwise using the Mann-Whitney U test.Results:Of the 58 patients included, 67.2% were male. The median age was 69.4 years (44-89). The average time of disease evolution was 14.8 (+9.3) years. Although the most frequent initial symptom was thoraco-lumbar pain (39.7%), hip complaints were initially present in 13.8%. 22,6% of patients did not fulfil Resnick classification criteria. Hip involvement was identified in 53.4% and a 61,3% the cartilage space were preserved. In the bivariate analysis, hip involvement was associated with female sex, a reduction in the intermaleolar distance (IM) and the presence of certain enthesopathies (greater trochanter, superior iliac spines and distal patellar entheses). The acetabular ossifications were significantly related to the mixed pattern compared to the other possible phenotypes of the disease.Conclusion:Hip involvement has been described in more than 50% of our patients. We found out that it was associated with female sex and a more broad ossification phenotype (mixed pattern). The measurement of IM distance could be useful for the clinical evaluation of this condition. Ossifications of other pelvic ring entheses were more observed in association with acetabular hyperostosis than other peripheral insertions.References:[1]Jung-Mo Hwang, Deuk-Soo Hwang, Chan Kang, Woo-Yong Lee, et al. Arthroscopic Treatment for Femoroacetabular Impingement with Extraspinal Diffuse Idiopathic Skeletal Hyperostosis. Clin Orthop Surg 2019; 11: 275–281.Disclosure of Interests: :Teresa Clavaguera Speakers bureau: novartis, BMS, Faes, Eulàlia Armengol Speakers bureau: Novartis, Maria Buxó: None declared, Marta Valls: None declared, Eulàlia DE CENDRA: None declared, Patricia Reyner Speakers bureau: Faes, Sanofi

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Harlianto, Netanja, Jan Westerink, Wouter Foppen, Marjolein Hol, Rianne Wittenberg, Pieternella van der Veen, Bram van Ginneken, et al. "Visceral Adipose Tissue and Different Measures of Adiposity in Different Severities of Diffuse Idiopathic Skeletal Hyperostosis." Journal of Personalized Medicine 11, no. 7 (July 15, 2021): 663. http://dx.doi.org/10.3390/jpm11070663.

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Background: Diffuse idiopathic skeletal hyperostosis (DISH) is associated with both obesity and type 2 diabetes. Our objective was to investigate the relation between DISH and visceral adipose tissue (VAT) in particular, as this would support a causal role of insulin resistance and low grade inflammation in the development of DISH. Methods: In 4334 patients with manifest vascular disease, the relation between different adiposity measures and the presence of DISH was compared using z-scores via standard deviation logistic regression analyses. Analyses were stratified by sex and adjusted for age, systolic blood pressure, diabetes, non-HDL cholesterol, smoking status, and renal function. Results: DISH was present in 391 (9%) subjects. The presence of DISH was associated with markers of adiposity and had a strong relation with VAT in males (OR: 1.35; 95%CI: 1.20–1.54) and females (OR: 1.43; 95%CI: 1.06–1.93). In males with the most severe DISH (extensive ossification of seven or more vertebral bodies) the association between DISH and VAT was stronger (OR: 1.61; 95%CI: 1.31–1.98), while increased subcutaneous fat was negatively associated with DISH (OR: 0.65; 95%CI: 0.49–0.95). In females, increased subcutaneous fat was associated with the presence of DISH (OR: 1.43; 95%CI: 1.14–1.80). Conclusion: Markers of adiposity, including VAT, are strongly associated with the presence of DISH. Subcutaneous adipose tissue thickness was negatively associated with more severe cases of DISH in males, while in females, increased subcutaneous adipose tissue was associated with the presence of DISH.

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Oudkerk, Sytse F., Firdaus A. A. Mohamed Hoesein, F. Cumhur Öner, Jorrit-Jan Verlaan, Pim A. de Jong, Jonneke S. Kuperus, Michael Cho, et al. "Diffuse Idiopathic Skeletal Hyperostosis in Smokers and Restrictive Spirometry Pattern: An Analysis of the COPDGene Cohort." Journal of Rheumatology 47, no. 4 (May 1, 2019): 531–38. http://dx.doi.org/10.3899/jrheum.181357.

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Objective.Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by bony proliferation at sites of tendinous and ligamentous insertions in the spine. Spinal mobility is reduced in DISH and may affect movement in the thorax, potentially leading to restrictive pulmonary function. This study investigated whether DISH is associated with restrictive spirometric pattern (RSP) in former and current smokers.Methods.Participants (n = 1784) with complete postbronchodilator spirometry who did not meet spirometric criteria for chronic obstructive pulmonary disease (COPD) at time of enrollment in the COPDGene study were included in this study. Subjects were classified as RSP if they had forced expiratory volume in 1 s(FEV1) to forced vital capacity (FVC) ratio > 0.7 with an FVC < 80%. Computed tomography (CT) scans were scored for the presence of DISH in accordance with the Resnick criteria. Chest CT measures of interstitial and alveolar lung disease, clinical symptoms, health surveys, and 6-min walking distance were recorded. Uni- and multivariable analyses were performed to test the association of DISH with RSP.Results.DISH was present in 236 subjects (13.2%). RSP was twice as common in participants with DISH (n = 90/236, 38.1%) compared to those without DISH (n = 301/1548, 19.4%; p < 0.001). In multivariable analysis, DISH was significantly associated with RSP (OR 1.78; 95% CI 1.22–2.60; p = 0.003) after adjusting for potential confounders. The RSP group with and without DISH had significantly worse spirometry, dyspnea, St. George’s Respiratory Questionnaire score, BODE index (Body mass index, airflow Obstruction, Dyspnea and Exercise capacity), and Medical Outcomes Study Short Form-36 questionnaire score.Conclusion.In heavy smokers with an FEV1/FVC ratio > 0.70, DISH is associated with RSP after adjustment for intrinsic and extrinsic causes of restrictive lung function. (Clinical trial registration number: NCT00608764.)

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