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Diffuse idiopathic skeletal hyperostosis (DISH)

Case contributed by Roberto Schubert
Diagnosis certain

Presentation

Chronic polyarthalgia. Stiffness of joints and spine.

Patient Data

Age: 65 years
Gender: Male

Ossification of the anterior longitudinal ligament only sparing the segments C2/3 and L4/5. Thoracic and partly lumbar epispinal ligament ossifications. Fabellae nuchae at C4,5. Suspected acquired atlanto-occipital assimilation. No evidence of sacroiliitis on the AP images of the lumbar spine.

Ossification of the ligamentous insertions at the acetabulum.

Fibroostoses at the insertions of the iliotibial bands, the patellar apices and the right patellar base. Partial ossification of the proximal interosseous membrane left > right.

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