Rheumatology, Ha'Emek MC, Afula, Israel.
Rheumatologie Ruhr-Universität Bochum, Rheumazentrum Ruhrgebiet, Herne, Germany
RMD Open. 2020 Feb;6(1). doi: 10.1136/rmdopen-2019-001151.
Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterised by calcification and ossification of ligaments and entheses. The condition usually affects the axial skeleton, in particular, at the thoracic segment, though also other portions of the spine are often involved. DISH often involves also peripheral tendinous and/or entheseal sites either alone, or in association with the involvement of peripheral joints. At times, new bone formation involves the bone itself, but sometimes it involves joints not usually affected by osteoarthritis (OA) which result in bony enlargement of the epiphysis, joints space narrowing and a reduced range of motion. Because of the entheseal involvement, DISH can be mistaken for seronegative spondyloarthropathies or for a "simple" OA. Furthermore, other implications for the recognition of DISH include spinal fractures, difficult intubation and upper endoscopies, decreased response rates in DISH with concomitant spondyloarthritides, and increased likelihood to be affected by metabolic syndrome and cardiovascular diseases. This Atlas is intended to show the imaging finding in DISH in patients diagnosed with the condition by the Resnick classification criteria.
弥漫特发性骨肥厚（DISH）是一种以韧带和肌腱附着点钙化和骨化为特征的疾病。该疾病通常影响轴向骨骼，特别是在胸段，但也常涉及脊柱的其他部分。DISH 通常还涉及外周肌腱和/或附着点，无论是单独的，还是与外周关节受累有关。有时，新骨形成涉及骨骼本身，但有时涉及通常不受骨关节炎（OA）影响的关节，导致骨骺骨增大、关节间隙变窄和运动范围减小。由于附着点受累，DISH 可能被误诊为血清阴性脊柱关节病或“单纯”OA。此外，对 DISH 的其他认识包括脊柱骨折、插管和上内窥镜检查困难、DISH 合并脊柱关节炎的反应率降低，以及更有可能受到代谢综合征和心血管疾病的影响。该图谱旨在展示通过 Resnick 分类标准诊断为 DISH 的患者的影像学表现。
