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

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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.

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Author notes

  1. Merav Lidar and Iris Eshed contributed equally to this work.

Authors and Affiliations

  1. Department of Diagnostic Imaging, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, 52621, Tel Aviv, Israel

    Shani Broitman, Myriam Stern & Iris Eshed

  2. Department of Orthopedic Surgery, Assuta Ashdod Medical Center, Ashdod, affiliated to Ben Gurion University, Beer Sheva, Israel

    Amir Herman

  3. Rheumatology Unit, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Merav Lidar

Authors
  1. Shani Broitman
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  2. Amir Herman
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Correspondence to Iris Eshed.

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Broitman, S., Herman, A., Stern, M. et al. Enthesopathy of the anterior chest wall joints in patients with diffuse idiopathic skeletal hyperostosis (DISH): a retrospective analysis of computed tomography scans. Skeletal Radiol 49, 461–467 (2020). https://doi.org/10.1007/s00256-019-03307-9

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  • DOI: https://doi.org/10.1007/s00256-019-03307-9

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