Diffuse Idiopathic Skeletal Hyperostosis eMedicine Radiology

Description: Paraspinal ligaments undergo degeneration, secondary to attrition, and often ossify. This condition is broadly termed spinal enthesopathy. Physicians recognize 3 syndromes associated with this phenomenon, including (1) Forestier disease (most common; involving anterior longitudinal ligaments) and a more diffuse variant (exhibiting additional extra-axial features) that is termed diffuse idiopathic skeletal hyperostosis (DISH), (2) ossification of the posterior longitudinal ligament (OPLL), and (3) ossification of the vertebral arch ligaments (OVAL). Clinically, DISH is often referred to as senile ankylosing spondylitis because of similarities in appearance between these two conditions, despite the differing ages of onset.