Evolutive particularities in Diffuse Idiopathic Skeletal Hyperostosis associated with Spinal Stenosis – case report

Diffuse idiopathic skeletal hyperostosis is a non-inflammatory disease, that affects mostly males and the principal manifestations are calcification and ossification of spinal ligaments, calcification of the tendons and ligaments in the vertebral body insertion. Clinical manifestations of the disease are mainly in the thoracic spine, but it may involve also the cervical and the lumbar spine. Extraspinal involvements are frequently present at patients with diffuse idiopathic skeletal hyperostosis. Spinal stenosis is associated with this disease.

The present case is of a 56 years old man, initially diagnosed with Ankyloses spondylitis, who was under a treatment with Sulfasalazin for approximately 7 years, afterwards the diagnosis was infirmed and he was diagnosed with “Diffuse idiopathic skeletal hyperostosis”.

The patient has multiple extra spinal manifestations of the disease (shoulders, elbows, hips, knees), cervical and lumbar spinal stenosis with clinical manifestations and imagistic confirmation, and also treated in neurosurgical service for several times, for the lumbar spine pathology. Particularities of this case are related with the delay of a correct diagnosis which means that the anterior treatments, both medical and surgical are under the questions.