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Case of the Week 542



What is the most likely diagnosis?

  • 64 year-old with back pain



Lateral View of the Chest

  1. Degenerative Disk Disease
  2. Ankylosing Spondylitis
  3. Juvenile Kyphosis
  4. Flourosis
  5. Diffuse Idiopathic Skeletal Hyperostosis

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Answer:

 

5. Diffuse Idiopathic Skeletal Hyperostosis

 

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Diffuse Idiopathic Skeletal Hyperostosis

General Considerations

  • More common in Caucasian males aged 50-75 years
  • Ossification of anterior longitudinal ligament with or without osteophytes is the primary pathology
  • DISH is an enthesopathy – there is reaction at the sites of tendinous insertions (entheses)
  • Laminated, flowing ossification
  • Should involve four contiguous vertebral bodies

MORE . . .

 


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is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.