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Published in: Skeletal Radiology 3/2020

01-03-2020 | Enthesopathy | Scientific Article

Enthesopathy of the anterior chest wall joints in patients with diffuse idiopathic skeletal hyperostosis (DISH): a retrospective analysis of computed tomography scans

Authors: Shani Broitman, Amir Herman, Myriam Stern, Merav Lidar, Iris Eshed

Published in: Skeletal Radiology | Issue 3/2020

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Abstract

Purpose

To evaluate and characterize anterior chest wall (ACW) joint’s enthesopathy on CT scans in patients with DISH compared with age- and gender-matched control group.

Material and methods

Retrospective evaluation for enthesopathy features of ACW joints—sterno-clavicular (SCJ), manubrio-sternal (MSJ), costo-sternal 1–7 (CSJ)—on chest CT scans of subjects with DISH (Resnick criteria) and of age- and gender-matched control subjects was performed. 183 subjects (DISH: 92, control: 91); male:female: 126:57, average age: 71.7 years (range 50–94) were evaluated. Total enthesopathy scores per subjects and per each joint were compared.

Results

Total enthesopathy score of ACW joints was significantly higher among DISH compared to controls (64.03 ± 15.1, 50.47 ± 12.4, p < 0.001). At joint level, SCJ and CSJ enthesopathy, but not MSJ was significantly more prevalent in DISH compared to controls.

Conclusion

ACW joints’ enthesopathy as seen on CT scans, an entity not included in the Resnick classification criteria, is common among DISH subjects. The difference between SCJ and CSJ prevalence compared to MSJ may result from different joint type. ACW joints’ enthesopathy may be considered to be included in future modified radiographic criteria for DISH.
Literature
1.
go back to reference Resnick D, Niwayama G. Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). Radiology. 1976;119(3):559–68.CrossRef Resnick D, Niwayama G. Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). Radiology. 1976;119(3):559–68.CrossRef
2.
go back to reference Mader R, Buskila D, Verlaan JJ, Atzeni F, Olivieri I, Pappone N, et al. Developing new classification criteria for diffuse idiopathic skeletal hyperostosis: back to square one. Rheumatology (Oxford). 2013;52(2):326–30.CrossRef Mader R, Buskila D, Verlaan JJ, Atzeni F, Olivieri I, Pappone N, et al. Developing new classification criteria for diffuse idiopathic skeletal hyperostosis: back to square one. Rheumatology (Oxford). 2013;52(2):326–30.CrossRef
3.
go back to reference Yaniv G, Bader S, Lidar M, Herman A, Shazar N, Aharoni D, et al. The natural course of bridging osteophyte formation in diffuse idiopathic skeletal hyperostosis: retrospective analysis of consecutive CT examinations over 10 years. Rheumatology. 2014;53(11):1951–7.CrossRef Yaniv G, Bader S, Lidar M, Herman A, Shazar N, Aharoni D, et al. The natural course of bridging osteophyte formation in diffuse idiopathic skeletal hyperostosis: retrospective analysis of consecutive CT examinations over 10 years. Rheumatology. 2014;53(11):1951–7.CrossRef
4.
go back to reference Mader R, Verlaan JJ, Buskila D. Diffuse idiopathic skeletal hyperostosis: clinical features and pathogenic mechanisms. Nat Rev Rheumatol. 2013;9(12):741–50.CrossRef Mader R, Verlaan JJ, Buskila D. Diffuse idiopathic skeletal hyperostosis: clinical features and pathogenic mechanisms. Nat Rev Rheumatol. 2013;9(12):741–50.CrossRef
5.
go back to reference Kuperus JS, Oudkerk SF, Foppen W, Mohamed Hoesein FA, Gielis WP, Waalwijk J, et al. Criteria for early-phase diffuse idiopathic skeletal hyperostosis: development and validation. Radiology. 2019;291(2):420–6.CrossRef Kuperus JS, Oudkerk SF, Foppen W, Mohamed Hoesein FA, Gielis WP, Waalwijk J, et al. Criteria for early-phase diffuse idiopathic skeletal hyperostosis: development and validation. Radiology. 2019;291(2):420–6.CrossRef
6.
go back to reference Belanger TA, Rowe DE. Diffuse idiopathic skeletal hyperostosis: musculoskeletal manifestations. J Am Acad Orthop Surg. 2001;9(4):258–67.CrossRef Belanger TA, Rowe DE. Diffuse idiopathic skeletal hyperostosis: musculoskeletal manifestations. J Am Acad Orthop Surg. 2001;9(4):258–67.CrossRef
7.
go back to reference Mader R, Sarzi-Puttini P, Atzeni F, Olivieri I, Pappone N, Verlaan JJ, et al. Extraspinal manifestations of diffuse idiopathic skeletal hyperostosis. Rheumatology (Oxford). 2009;48(12):1478–81.CrossRef Mader R, Sarzi-Puttini P, Atzeni F, Olivieri I, Pappone N, Verlaan JJ, et al. Extraspinal manifestations of diffuse idiopathic skeletal hyperostosis. Rheumatology (Oxford). 2009;48(12):1478–81.CrossRef
8.
go back to reference Slonimsky E, Leibushor N, Aharoni D, Lidar M, Eshed I. Pelvic enthesopathy on CT is significantly more prevalent in patients with diffuse idiopathic skeletal hyperostosis (DISH) compared with matched control patients. Clin Rheumatol. 2016;35(7):1823–7.CrossRef Slonimsky E, Leibushor N, Aharoni D, Lidar M, Eshed I. Pelvic enthesopathy on CT is significantly more prevalent in patients with diffuse idiopathic skeletal hyperostosis (DISH) compared with matched control patients. Clin Rheumatol. 2016;35(7):1823–7.CrossRef
9.
go back to reference Beyeler C, Thomann SR, Gerber NJ, Kunze C, Aeberli D. Diffuse idiopathic skeletal hyperostosis (DISH) of the elbow: a controlled radiological study. BMC Musculoskelet Disord. 2015;16:119.CrossRef Beyeler C, Thomann SR, Gerber NJ, Kunze C, Aeberli D. Diffuse idiopathic skeletal hyperostosis (DISH) of the elbow: a controlled radiological study. BMC Musculoskelet Disord. 2015;16:119.CrossRef
10.
go back to reference Littlejohn GO, Urowitz MB. Peripheral enthesopathy in diffuse idiopathic skeletal hyperostosis (DISH): a radiologic study. J Rheumatol. 1982;9(4):568–72.PubMed Littlejohn GO, Urowitz MB. Peripheral enthesopathy in diffuse idiopathic skeletal hyperostosis (DISH): a radiologic study. J Rheumatol. 1982;9(4):568–72.PubMed
11.
go back to reference Mader R, Novofastovski I, Iervolino S, Pavlov A, Chervinsky L, Schwartz N, et al. Ultrasonography of peripheral entheses in the diagnosis and understanding of diffuse idiopathic skeletal hyperostosis (DISH). Rheumatol Int. 2015;35(3):493–7.CrossRef Mader R, Novofastovski I, Iervolino S, Pavlov A, Chervinsky L, Schwartz N, et al. Ultrasonography of peripheral entheses in the diagnosis and understanding of diffuse idiopathic skeletal hyperostosis (DISH). Rheumatol Int. 2015;35(3):493–7.CrossRef
12.
go back to reference Benjamin M, Toumi H, Suzuki D, Redman S, Emery P, McGonagle D. Microdamage and altered vascularity at the enthesis-bone interface provides an anatomic explanation for bone involvement in the HLA-B27-associated spondylarthritides and allied disorders. Arthritis Rheum. 2007;56(1):224–33.CrossRef Benjamin M, Toumi H, Suzuki D, Redman S, Emery P, McGonagle D. Microdamage and altered vascularity at the enthesis-bone interface provides an anatomic explanation for bone involvement in the HLA-B27-associated spondylarthritides and allied disorders. Arthritis Rheum. 2007;56(1):224–33.CrossRef
13.
go back to reference Rennie WJ, Jans L, Jurik AG, Sudol-Szopinska I, Schueller-Weidekamm C, Eshed I. Anterior chest wall in axial spondyloarthritis: imaging, interpretation, and differential diagnosis. Semin Musculoskelet Radiol. 2018;22(2):197–206.CrossRef Rennie WJ, Jans L, Jurik AG, Sudol-Szopinska I, Schueller-Weidekamm C, Eshed I. Anterior chest wall in axial spondyloarthritis: imaging, interpretation, and differential diagnosis. Semin Musculoskelet Radiol. 2018;22(2):197–206.CrossRef
14.
go back to reference Jurik AG. Anterior chest-wall involvement in seronegative arthritides: a study of the frequency of changes at radiography. Rheumatol Int. 1992;12(1):7–11.CrossRef Jurik AG. Anterior chest-wall involvement in seronegative arthritides: a study of the frequency of changes at radiography. Rheumatol Int. 1992;12(1):7–11.CrossRef
15.
go back to reference Leibushor N, Slonimsky E, Aharoni D, Lidar M, Eshed I. CT abnormalities in the sacroiliac joints of patients with diffuse idiopathic skeletal hyperostosis. Am J Roentgenol. 2017;208(4):834–7.CrossRef Leibushor N, Slonimsky E, Aharoni D, Lidar M, Eshed I. CT abnormalities in the sacroiliac joints of patients with diffuse idiopathic skeletal hyperostosis. Am J Roentgenol. 2017;208(4):834–7.CrossRef
16.
go back to reference Restrepo CS, Martinez S, Lemos DF, Washington L, McAdams HP, Vargas D, et al. Imaging appearances of the sternum and sternoclavicular joints. Radiographics. 2009;29(3):839–59.CrossRef Restrepo CS, Martinez S, Lemos DF, Washington L, McAdams HP, Vargas D, et al. Imaging appearances of the sternum and sternoclavicular joints. Radiographics. 2009;29(3):839–59.CrossRef
17.
go back to reference Hardcastle SA, Dieppe P, Gregson CL, Arden NK, Spector TD, Hart DJ, et al. Osteophytes, Enthesophytes, and high bone mass a bone-forming triad with potential relevance in osteoarthritis. Arthritis Rheum. 2014;66(9):2429–39.CrossRef Hardcastle SA, Dieppe P, Gregson CL, Arden NK, Spector TD, Hart DJ, et al. Osteophytes, Enthesophytes, and high bone mass a bone-forming triad with potential relevance in osteoarthritis. Arthritis Rheum. 2014;66(9):2429–39.CrossRef
18.
go back to reference Mader R. Diffuse idiopathic skeletal hyperostosis: a distinct clinical entity. Isr Med Assoc J. 2003;5(7):506–8.PubMed Mader R. Diffuse idiopathic skeletal hyperostosis: a distinct clinical entity. Isr Med Assoc J. 2003;5(7):506–8.PubMed
Metadata
Title
Enthesopathy of the anterior chest wall joints in patients with diffuse idiopathic skeletal hyperostosis (DISH): a retrospective analysis of computed tomography scans
Authors
Shani Broitman
Amir Herman
Myriam Stern
Merav Lidar
Iris Eshed
Publication date
01-03-2020
Publisher
Springer Berlin Heidelberg
Keyword
Enthesopathy
Published in
Skeletal Radiology / Issue 3/2020
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-019-03307-9

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