Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
Department of Orthopedic Surgery, Shiga University of Medical Science, Ōtsu, Shiga, Japan.
Sci Rep. 2023 Feb 1;13(1):1849. doi: 10.1038/s41598-023-28946-w.
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.
利用全脊柱 CT 评估弥漫性特发性骨肥厚（DISH）和强直性脊柱炎（AS）的影像学差异，包括脊柱和骶髂关节（SIJ）。对 111 例经全脊柱 CT 诊断为 DISH 和 27 例 AS 的患者进行脊柱韧带骨化和桥接、关节突关节和 SIJ 融合的评估。还评估了前桥接的数量和桥接的形状（蜡烛样/光滑样）。我们通过匹配 DISH 和 AS 患者的年龄和性别进一步评估了他们。完全的 SIJ 融合在 AS 中更为常见，而在 DISH 中更常见的是 SIJ 周围的前后骨桥。然而，63%的 DISH 患者存在部分或完全融合。在脊柱前骨桥中，大多数 AS 患者为光滑型，而 DISH 患者为蜡烛样型。然而，一些 DISH 患者（11%）为光滑型。椎间关节融合在 AS 中更为常见。AS 患者的前脊柱骨桥数量多于 DISH 患者，尤其是在腰椎。这些结果有助于区分 DISH 和 AS，因此在诊断时应考虑这些结果。
