most symptomatic patients have reduced mobility of the spine associated with back pain
disease usually affects the thoracic spine
other possible features include:
peripheral joints manifestations
peripheral joint involvement in DISH has some distinctive features (1,2,3,4):
involvement of joints usually unaffected by primary osteoarthritis (OA - e.g., hip and knee)
osteoarthritis involving joints usually not affected by OA such as the elbow and shoulder
foot and ankle involvement has been reported in up to 70% of patients
clinical and radiographic findings are often consistent with heel spurs, Achilles tendinitis, and plantar fasciitis
increased hypertrophic changes compared with primary OA
prominent enthesopathies adjacent to peripheral joints
enthesopathies related to joints (ie, tibial tuberosity, elbow) and in sites unrelated to joints (ie, plantar fascia, iliolumbar ligament)
calcification and ossification of entheses in sites other than the joints
peripheral findings often include hyperostosis and tendonitis
in the pelvis, enthesophytes involving the iliac wing and ischial tuberosity may be present
periarticular hyperostosis and tendinous ossifications have also been reported in the hip, knee, shoulder, elbow, hand, and wrist
Reference:
Beyeler C, Schlapbach P, Gerber NJ, et al. Diffuse idiopathic skeletal hyperostosis (DISH) of the elbow: a cause of elbow pain? A controlled study. Br J Rheumatol 1992;31:319-23.
Littlejohn JO, Urowitz MB, Smythe HA, et al. Radiographic features of the hand in diffuse idiopathic skeletal hyperostosis (DISH). Radiology 1981;140:623-9.
Beyeler C, Schlapbach P, Gerber NJ, et al. Diffuse idiopathic skeletal hyperostosis (DISH) of the shoulder: a cause of shoulder pain? Br J Rheumatol 1990;29:349-53.
T . David Luo; Matthew Varacallo. Diffuse Idiopathic Skeletal Hyperostosis (DISH). StatPearls.
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