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Ankylosing spondylitis
7%
281/4183
Cervical myelopathy
0%
17/4183
Congenital spinal stenosis
1%
22/4183
Diffuse idiopathic skeletal hyperostosis
91%
3801/4183
Ossification of posterior longitudinal ligament
38/4183
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Diffuse idiopathic skeletal hyperostosis (DISH) is a common disorder of unknown etiology that is characterized by back pain and spinal stiffness. The condition is recognized radiographically by the presence of "flowing" ossification along the anterolateral margins of at least four contiguous vertebrae and the absence of changes of spondyloarthropathy or degenerative spondylosis. It is a challenge to differentiate between DISH and ankylosing spondylitis. Features that help distinguish DISH from AS include: 1) nonmarginal syndesmophytes as shown in Illustration A (AS is marginal). 2) no involvement of SI joint (biliateral sacroiliitis in AS). 3) anterior cervical bone formation with preservation of disc space as seen in Illustration B (AS will typicall show bone formation between vertebral bodies as seen in Illustration C). 4) Radiographic findings on the right side of the thoracic spine. The reference by Belanger et al is a review article that discusses the diagnosis and treatment of both spinal and extraspinal manifestations of DISH. The reference by di Girolamo et al found an increased prevalence of vertebral osteochondrosis (degenerative disc disease) in younger DISH patients with respect to controls.
4.4
(42)
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