Pelvic manifestations of diffuse idiopathic skeletal hyperostosis (DISH): are they clinically relevant?

Abstract

This is a cross-sectional, case-controlled study on the clinical relevance of diffuse idiopathic skeletal hyperostosis (DISH) in relation to the pelvic girdle. Thirty-two rheumatology patients with DISH were compared with 35 dermatology control subjects in respect to the clinical parameters pain and passive hip joint motion in a standardized manner. There were no significant differences between the two groups, indicating no major clinical relevance of DISH in the pelvic region. In a second study, the radiographs of 23 DISH probands were compared blindly with 23 matched controls. The only significant difference was a much higher degree of severe juxtaarticular bone formation in DISH probands. The majority of these spurs proved to be asymptomatic and did not affect the range of passive hip joint mobility. DISH is a frequently seen, often radiologically very impressive phenomenon of little clinical relevance, at least in the pelvic area.