Skip to main content

Advertisement

SpringerLink
Log in

A case of diffuse idiopathic hyperostosis of bone (DISH) in a patient on hemodialysis

  • Case Report
  • Published:
CEN Case Reports Aims and scope Submit manuscript

Abstract

Diffuse idiopathic skeletal hyperostosis (DISH) is a noninflammatory progressive disease resulting in ossification of the anterior longitudinal ligament of the spine and tendons. Herein, we describe a case of DISH in a patient on long-term hemodialysis. The patient was a 79-year-old man undergoing hemodialysis for chronic kidney disease due to diabetic nephropathy. He presented to the emergency department complaining of back pain after a slip and fall. Radiographs revealed bamboo spine-like findings, extending from the cervical to the lumbar spine. Computed tomography and magnetic resonance imaging revealed a compression fracture of thoracic vertebra 12, with abnormal ossification of the anterior longitudinal ligament. Inter-vertebral vertical osseous bridges were also observed at the cervical 7 and lumbar 2 vertebrae. There was no obvious spinal cord compression. Leukocytosis and C-reactive protein levels were not elevated and the human leukocyte type antigen HLA-B27 test was negative. Based on this finding, a diagnosis of DISH was made. In the absence of neurological findings, the patient was treated conservatively. Our findings show an overlap between the clinical features of DISH and those of hemodialysis patients, including older age, male sex, and diabetes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Resnick D, Shaul SR, Robins JM. Diffuse idiopathic skeletal hyperostosis (DISH): Forestier’s disease with extraspinal manifestations. Radiology. 1975;115:513–24.

    Article  CAS  PubMed  Google Scholar 

  2. Forestier J, Rotes-Querol J. Senile ankylosing hyperostosis of the spine. Ann Rheum Dis. 1950;9:321–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Mader R, Verlaan JJ, Buskila D. Diffuse idiopathic skeletal hyperostosis: clinical features and pathogenic mechanisms. Nat Rev Rheumatol. 2013;9:741–50.

    Article  PubMed  Google Scholar 

  4. Weinfeld RM, Olson PN, Maki DD, Griffiths HJ. The prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in two large American Midwest metropolitan hospital populations. Skeletal Radiol. 1997;26:222–5.

    Article  CAS  PubMed  Google Scholar 

  5. Westerveld LA, van Ufford HM, Verlaan JJ, Oner FC. The prevalence of diffuse idiopathic skeletal hyperostosis in an outpatient population in The Netherlands. J Rheumatol. 2008;35:1635–8.

    PubMed  Google Scholar 

  6. Kagotani R, Yoshida M, Muraki S, et al. Prevalence of diffuse idiopathic skeletal hyperostosis (DISH) of the whole spine and its association with lumbar spondylosis and knee osteoarthritis: the ROAD study. J Bone Miner Metab. 2015;33:221–9.

    Article  CAS  PubMed  Google Scholar 

  7. Kiss C, Szilagyi M, Paksy A, Poor G. Risk factors for diffuse idiopathic skeletal hyperostosis: a case-control study. Rheumatology (Oxford). 2002;41:27–30.

    Article  CAS  PubMed  Google Scholar 

  8. Pappone N, Ambrosino P, Di Minno MND, Iervolino S. Is diffuse idiopathic skeletal hyperostosis a disease or a syndrome? Rheumatology. 2016;56:1635–6.

    Google Scholar 

  9. Harlianto NI, Westerink J, Hol ME, Wittenberg R, Foppen W, van der Veen PH, et al. Patients with diffuse idiopathic skeletal hyperostosis have an increased burden of thoracic aortic calcifications. Rheumatol Adv Pract. 2022;6:rkac060.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Mata S, Fortin PR, Fitzcharles MA, et al. A controlled study of diffuse idiopathic skeletal hyperostosis. Clinical features and functional status. Medicine (Baltimore). 1997;76:104–17.

    Article  CAS  PubMed  Google Scholar 

  11. Resnick D, Shapiro RF, Wiesner KB, Niwayama G, Utsinger PD, Shaul SR. Diffuse idiopathic skeletal hyperostosis (DISH) [ankylosing hyperostosis of Forestier and Rotes-Querol]. Semin Arthritis Rheum. 1978;7:153–87.

    Article  CAS  PubMed  Google Scholar 

  12. Caron T, Bransford R, Nguyen Q, Agel J, Chapman J, Bellabarba C. Spine fractures in patients with ankylosing spinal disorders. Spine (Phila Pa 1976). 2010;35:E45864.

    Article  Google Scholar 

  13. Mader R, Novofastovski I, Rosner E, Adawi M, Herer P, Buskila D. Nonarticular tenderness and functional status in patients with diffuse idiopathic skeletal hyperostosis. J Rheumatol. 2010;37:1911–6.

    Article  PubMed  Google Scholar 

  14. Westerveld LA, Verlaan JJ, Oner FC. Spinal fractures in patients with ankylosing spinal disorders: a systematic review of the literature on treatment, neurological status and complications. Eur Spine J. 2009;18:145–56.

    Article  CAS  PubMed  Google Scholar 

  15. Raggi P, Bellasi A, Bushinsky D, Bover J, Rodriguez M, Ketteler M, et al. Slowing progression of cardiovascular calcification with SNF472 in patients on hemodialysis: Results of a randomized phase 2b study. Circulation. 2020;141:728–39.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nephrology, Showa University Koto Toyosu Hospital, Yokohama Hospital, Kanagawa, Japan

    Yuki Mima

  2. Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Chigasaki-Chuo 35-1, Tsuzuki, Kanagawa, Yokohama, 224-8503, Japan

    Kiryu Yoshida, Masahiro Yamamoto & Hidetoshi Ito

Authors
  1. Yuki Mima
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kiryu Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masahiro Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hidetoshi Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kiryu Yoshida.

Ethics declarations

Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

All procedures were performed in accordance with the ethical standards of our institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the patient for publication of this case report.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mima, Y., Yoshida, K., Yamamoto, M. et al. A case of diffuse idiopathic hyperostosis of bone (DISH) in a patient on hemodialysis. CEN Case Rep 12, 226–229 (2023). https://doi.org/10.1007/s13730-022-00755-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13730-022-00755-6

Keywords

Search

Navigation