From the Department of Orthopaedic Surgery, University of California Davis School of Medicine, Sacramento, CA.
J Am Acad Orthop Surg. 2021 Dec 15;29(24):1044-1051. doi: 10.5435/JAAOS-D-20-01344.
Diffuse idiopathic skeletal hyperostosis (DISH) is an ankylosing condition affecting up to 32.5% of the general cohort. Although often asymptomatic, affected individuals may present with back pain, stiffness, dysphagia, functional decline, and neurologic deficits. Radiographically, DISH is characterized by flowing ossifications along the anterior spine spanning ≥4 vertebral bodies. Although the etiology of DISH remains unknown, diabetes mellitus and other metabolic derangements are strongly associated with DISH. Importantly, spinal ankylosis in DISH predisposes patients to unstable spine fractures from low-energy trauma, and careful consideration must be taken in managing these patients. This article reviews the epidemiology and pathophysiology of DISH, and its clinical findings, diagnostic criteria, and management.
弥漫特发性骨肥厚（DISH）是一种影响高达 32.5%普通人群的强直性疾病。尽管通常无症状，但受影响的个体可能会出现背痛、僵硬、吞咽困难、功能下降和神经功能缺损。放射学上，DISH 的特征是在前脊柱沿≥4 个椎体连续的流动骨化。尽管 DISH 的病因仍不清楚，但糖尿病和其他代谢紊乱与 DISH 密切相关。重要的是，DISH 中的脊柱强直使患者容易因低能量创伤而发生不稳定的脊柱骨折，因此在治疗这些患者时必须谨慎考虑。本文综述了 DISH 的流行病学和病理生理学及其临床表现、诊断标准和治疗。
