Available online xxxKeywords: Diffuse idiopathic skeletal hyperostosis (DISH) Flowing ossification Paraspinal phytes Extraspinal sites
1.Case report A 55-year-old man presented with history of pain and limitation of movements of right shoulder. He also gave history of neck and low back pain which were mechanical in nature. He was a known diabetic and was on oral hypoglycemic agents since the past 10 years with poor glycaemic control. On investigation inflammatory markers were negative. Plain radiographs anteroposterior view of thoracic spine showed flowing paraspinal phytes (Fig. 1) and lateral view of lumbar spine showed huge bony excrescences resembling osteophytosis with preserved disc spaces (Fig. 2). The plain radiograph of pelvis showed bony excrescences around the acetabular margin with whiskering of iliac crests and normal sacroiliac joints (Fig. 3). These radiographic pictures are characteristics of diffuse idiopathic skeletal hyperostosis (DISH). Ultrasonography of right shoulder was normal and a diagnosis of periarthritis of right shoulder was made clinically. Fig. 1 e Anteroposterior radiograph of thoracic spine show flowing paraspinal phytes.
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