Ossification of the posterior longitudinal ligament and DISH

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Being investigated for a fall.

Patient Data

Age: 65 years
Gender: Male

There are multiple large flowing osteophytes anteriorly between C4 and T1, consistent with diffuse idiopathic skeletal hyperostosis (DISH).

There is also ossification of the posterior longitudinal ligament (OPLL) particularly marked between C2 and C6. This causes moderate to severe stenosis of the central canal between C2 and C6.

No fracture of the cervical spine is demonstrated.

There is heterogenous enlargement of the thyroid gland with retrosternal extension and foci of hypoattenuation and calcification in keeping with a multinodular goiter. 

Case Discussion

OPLL and DISH are quite frequently seen together and an underlying genetic link has been postulated. 

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