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Unusual bridge ossification of pubic symphysis in diffuse idiopathic skeletal hyperostosis

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Diffuse idiopathic skeletal hyperostosis, also named Forestier’s disease, is a progressive skeletal disorder mainly affecting elderly men, characterized by ossification and calcification of entheses, ligaments, and joint capsules. It may affect both spine and extraspinal sites. A typical feature of the disease is the ossification diathesis that leads to the formation of osseous bridges across contiguous skeletal segments with predominant involvement of thoracic and cervical vertebrae [1]; moreover, sacroiliac joint bridging may be observed [2].

A 67-year-old man affected by metabolic syndrome (dyslipidemia, glucose intolerance, hyperuricemia, obesity, and high blood pressure) developed diffuse idiopathic skeletal hyperostosis; in addition to the typical involvement of five contiguous thoracic vertebral segments on the right side, X-ray imaging shows a very unusual and robust osseous bridge on the upper edge of the pubic symphysis (Fig. 1). To the best of our knowledge, this lesion of pubic symphysis in diffuse idiopathic skeletal hyperostosis was not previously reported.

Fig. 1
figure 1

Pelvis X-ray shows robust osseous bridge on the upper edge of the pubic symphysis

References

  1. Mader R, Sarzi-Puttini P, Atzeni F, Olivieri I, Pappone N, Verlaan JJ, Buskila D (2009) Extraspinal manifestations of diffuse idiopathic skeletal hyperostosis. Rheumatology 48:1478–1481

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  2. Dar G, Peleg S, Masharawi Y, Steinberg N, Rothschild BM, Hershkovitz I (2007) The association of sacroiliac joint bridging with other enthesopathies in the human body. Spine 32:E303–E308

    PubMed  Article  Google Scholar 

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Correspondence to Paola Caramaschi.

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Caramaschi, P., Biasi, D. Unusual bridge ossification of pubic symphysis in diffuse idiopathic skeletal hyperostosis. Rheumatol Int 32, 3701 (2012). https://doi.org/10.1007/s00296-011-2215-1

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  • DOI: https://doi.org/10.1007/s00296-011-2215-1

Keywords

  • Obesity
  • Metabolic Syndrome
  • High Blood Pressure
  • Glucose Intolerance
  • Hyperuricemia