Diffuse idiopathic skeletal hyperostosis: A diagnostic and therapeutic challenge

Abstract

A 74-year-old man who for 6 years presented cervical pain radiating to the dorsolumbar area, with physical activity as well as at rest, and progressive functional limitation of the neck for movements until flexion and rotation were compromised. The cervical spine X-ray showed cascade calcification of the
anterolateral aspect from C2 to C6, without compromising the height of the vertebral bodies; and, in the dorsolumbar spine showed hyperostosis of the contiguous dorsolumbar vertebral bodies, without affecting the sacroiliac joints. Diffuse idiopathic skeletal hyperostosis (DISH) is a disease characterized by calcification and ossification of different joint structures, affecting the cervical, dorsal or lumbar spine, with a predisposition to ossification of the anterior longitudinal ligament and, to a lesser extent, of the posterior longitudinal ligament.