This site is intended for healthcare professionals

CPD
CPD
Pro
Pro
account_circleSign in
Go to /sign-in page

You can view 5 more pages before signing in

Go to /pro/cpd-dashboard page

This page is worth 0.05 CPD credits. CPD dashboard

Go to /account/subscription-details page

This page is worth 0.05 CPD credits. Upgrade to Pro

Investigations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The blood biochemistry is normal, including calcium, phosphate & alkaline phosphatase. HLA-B27 and rheumatoid factor are negative.

Diabetes mellitus is commonly associated and a fasting glucose may be elevated.

  • blood tests - ESR, CRP, rheumatoid factor, and antinuclear antibody - are normal in DISH

  • radiography - AP and lateral spine imaging in patients with DISH demonstrate "flowing candle wax,"
    • describes the non-marginal syndesmophytes that project horizontally from the vertebrae and form extra-articular ankylosis
      • distinguishable from the vertical "bamboo spine" that forms intra-articular disc space ossification in ankylosing spondylitis (AS)
    • increased radiodensity, preservation of facet joints and disc spaces on spine imaging help further distinguish DISH from AS
    • may present with osteopenia and degenerative changes - note the association between DISH and low bone density remains controversial
    • thoracic spine is most commonly involved in DSH

Reference:

  • Belanger TA, Rowe DE. Diffuse idiopathic skeletal hyperostosis: musculoskeletal manifestations. J Am Acad Orthop Surg. 2001 Jul-Aug;9(4):258-67.

Create an account to add page annotations

Create a free account

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.