Littlejohn G O, Urowitz M B, Smythe H A, Keystone E C
Radiology. 1981 Sep;140(3):623-9. doi: 10.1148/radiology.140.3.7280223.
Radiographs of the hands of 25 men and 9 women with diffuse idiopathic skeletal hyperostosis (DISH) were compared with age- and sex-matched controls and acromegalic patients. Characteristics of DISH included broadening and "arrowheading" of the distal phalangeal tufts, enlarged sesamoid bones, increased cortical width of tubular bones, prominent enthesopathy in the proximal phalanges, exostoses (particularly at the metacarpophalangeal heads), and new bone in the joint capsule. There was no consistent change in soft-tissue measurements or cartilage width between DISH and control patients. Acromegaly could be differentiated from DISH by the relative lack of enthesopathy, marked soft-tissue changes, and increased cartilage width. Any metabolic factor responsible for the changes in DISH apparently acts primarily on the enthesis and bone but has little effect on soft-tissue or cartilage growth.
将25名患有弥漫性特发性骨肥厚（DISH）的男性和9名患有DISH的女性的手部X光片与年龄和性别匹配的对照组及肢端肥大症患者的X光片进行了比较。DISH的特征包括远节指骨粗隆增宽和呈“箭头状”、籽骨增大、管状骨皮质宽度增加、近节指骨明显的附着点病、骨赘形成（特别是在掌指关节头部）以及关节囊内出现新骨。在DISH患者和对照患者之间，软组织测量值或软骨宽度没有一致的变化。肢端肥大症可通过相对缺乏附着点病、明显的软组织改变和软骨宽度增加与DISH区分开来。任何导致DISH变化的代谢因素显然主要作用于附着点和骨骼，但对软组织或软骨生长影响很小。
