Chitten Jojin Jose, James Boblee
Orthopaedics, Sree Lakshmi Narayana Institute of Medical Sciences and Hospital, Puducherry, India
Orthopaedics, Sree Lakshmi Narayana Institute of Medical Sciences and Hospital, Puducherry, India.
BMJ Case Rep. 2019 Oct 31;12(10):e223740. doi: 10.1136/bcr-2017-223740.
Diffuse idiopathic skeletal hyperostosis (DISH) is a common degenerative enthesopathy seen in the elderly with male preponderance. It is uncommon in patients before 50 years of age and is extremely rare in patients younger than 40 years. We report a case of 33-year-old unmarried woman who presented with inflammatory spinal pain and stiffness, limited chest expansion, decreased range of spinal motion and postural abnormalities, all of which suggested the diagnosis of ankylosing spondylitis, considering the patient's age. But, further evaluation led us to the final diagnosis of DISH with associated metabolic syndrome and polycystic ovarian syndrome (PCOS). To the best of our knowledge, our patient is the first reported case of DISH in a woman less than 40 years of age, and also the first case of DISH associated with PCOS and metabolic syndrome.
弥漫性特发性骨肥厚（DISH）是一种常见的退行性附着点病，多见于老年人，男性居多。在50岁之前的患者中并不常见，在40岁以下的患者中极为罕见。我们报告一例33岁未婚女性，她出现炎性脊柱疼痛和僵硬、胸廓扩张受限、脊柱活动范围减小及姿势异常，考虑到患者年龄，所有这些表现提示强直性脊柱炎的诊断。但是，进一步评估使我们最终诊断为DISH，并伴有代谢综合征和多囊卵巢综合征（PCOS）。据我们所知，我们的患者是首例报道的年龄小于40岁的女性DISH病例，也是首例DISH合并PCOS和代谢综合征的病例。
