Comparison of radiological characteristics between diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis: a multicenter study

Abstract

To evaluate the radiological differences between diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) using whole spine computed tomography (CT), including the spine and sacroiliac joint (SIJ). The ossification and bridging of spinal ligament and fusion of the facet joint and SIJ were evaluated in 111 patients who were diagnosed with DISH and 27 patients with AS on the whole spine CT. The number of anterior bridging and shape of bridging (candle-wax-type/ smooth-type) were also evaluated. We further evaluated patients with DISH and AS by matching their age and sex. Complete SIJ fusion was more common in AS, whereas anterior and posterior bony bridging around SIJ was more common in DISH. However, 63% of patients with DISH had a partial or complete fusion. In spinal anterior bony bridging, the majority of patients with AS had the smooth-type, whereas those with DISH had the candle-wax-type. However, some of the patients with DISH (11%) had smooth-type. Intervertebral facet joint fusion is more common in AS. The number of anterior spinal bony bridging was greater in AS than in DISH, especially in the lumbar spine. These results are useful in differentiating DISH from AS and should therefore be considered when making a diagnosis.

Ankylosing Spondylitis: Special Considerations and Clinical Outcomes in Surgical Management of Spinal Fractures, Case Series and Analysis of Twenty Patients

“…AS is an in ammatory disease described in the literature by primary involvement of sacroiliacjoint(SIJ), followed by ascending enthesopathy and ectopic calci cation of anterior and posterior spinal ligament [17,18]. Thus, spinal column is vulnerable to trauma.…”

An example of a favorable outcome of a cervical spine injury occurring on a background of diffuse idiopathic skeletal hyperostosis: the result of an anthropological finding in the church of St. Peter in the town of Domashevo (Bosnia and Herzegovina)

“…Типичным рентгенологическим признаком АС является «бамбуковый стебель», а БФ -«струящаяся мантия» по типу свечного воска [22].…”

Significant Reduction in Bone Density as Measured by Hounsfield Units in Patients with Ankylosing Spondylitis or Diffuse Idiopathic Skeletal Hyperostosis

“…In comparison, those of DISH have a flowing “candlewax” appearance due to ossification of the anterior longitudinal ligament (ALL). DISH also appears to prefer the thoracic spine, whereas AS appears to involve both the thoracic and lumbar spine [ 10 , 11 ]. In both, marginal bone sclerosis can be accompanied by depletion of the vertebral body cancellous bone [ 12 , 13 ], reflected as reduced bone mineral density (BMD) within the autofused segments.…”