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

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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.

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  • 1. Helfgott S.M. Tugwell P. & Romain P.L. (2015). Diffuse idiopathic skeletal hyperostosis (DISH) UpToDate Retrieved Aprilie 6 2015 from UpToDate database on the World Wide Web : http://www.uptodate.com

  • 2. Nascimento F.A. Gatto L.A.M. Lages R.O. Neto H.M. Demartini Z. & Koppe G.L. (2014). Diffuse idiopathic skeletal hyperostosis : A review Surg Neurol Int 5(Suppl 3) S122-S125 DOI: 10.4103/2152-7806.130675

  • 3. Holton K.F. Denard P.J. Yoo J.U. Kado D.M. Barrett-Connor E. & Marshall L.M. Osteoporotic Fractures in Men (MrOS) Studz Group (2011) Diffuse idiopathic skeletal hyperostosis (DISH) and its relation to back pain among older men: The MrOS Study Semin Arthitis Rheum. 41(2) 131-138 DOI: 10.1016/j.semarthrit.2011.01.001

  • 4. Zhang C. Ruan D. He Q. Wen T. Yang P. (2014) Progressive dysphagia and neck pain due to diffuse idiopathic skeletal hyperostosis of the cervical spine: a case report and literature review Clinical Interventions in Aging. 9: 553-557 DOI: 10.2147/CIA.S60146

  • 5. Terzi R. (2014). Extraskeletal symptoms and comorbidities of diffuse idiopathic skeletal hyperostosis World J Clin Cases. 2(9): 422-425 DOI: 10.12998/wjcc.v2.i9.422

  • 6. Pillai S. & Littlejohn G. (2014) Metabolic factors in diffuse idiopathic skeletal hyperostosis – a review of clinical data The Open Rheumatology Journal. 8 116-128 DOI: 10.2174/1874312901408010116

  • 7. Najib J. Goutagnz S. Pezre M. Faillot T. & Kalamarides M (2014 Mar.) Forestier’s disease presenting with dysphagia and dysphonia PanAfrican Medical Journal. 17 168 DOI: 10.11604/pamj.2014.17.168.2453

  • 8. Storch M.J. Hubbe U. & Glocker F.X. (2007). Cervical myelopathy caused by soft-tissue mass in diffuse idiopathic skeletal hyperostosis Eur Spine J. 17(Suppl 2) S243-S247 DOI: 10.1007/s00586-007-0508-6

  • 9. Hasegawa K. Takahashi H. Iida Z. Zokozama Z. Fukutake K. Takamatsu R. Nakamura K. Suzuki D. Shishikura W. Tsuge S. Sekiguchi M. & Wada A. (2013). Spontaneous Symptomatic Pseudoarthrosis at the L2-L3 Intervertebral Space with Diffuse Idiopathic Skeletal Hyperostosis: A Case Report Orthopedics. 2013 Article ID 497458 4 DOI: 10.1155/2013/497458

  • 10. Diederichs G. Engelken F. Marshall L.M. Peters K. Black D.M. Issever A.S. Barrett-Connor E. Orwoll E. Hamm B. Link T.M. & Osteoporotic Fractures in Men (MrOS) Research Group (2010). Diffuse idiopathic skeletal hyperosotosis (DISH) relation to vertebral fractures and bone density. OsteoporosInt. 22 1789–1797 DOI: 10.1007/s00198-010-1409-9

  • 11. Levin K. Aminoff M.J. Atlas S.J. & Wilterdink J.L. (2013). Lumbar spinal stenosis: pathophysiology clinical features and diagnosis UpToDate Retrieved Aprilie 9 2015 from UpToDate database on the World Wide Web : http://www.uptodate.com

  • 12. Levin K. Aminoff M.J. & Wilterdink J.L. (2013) Cervical spondylotic myelopathy UpToDate Retrieved Aprilie 9 2015 from UpToDate database on the World Wide Web : http://www.uptodate.com

  • 13. Lucescu V. (2009). Afecţiunile degenerative ale coloanei vertebrale – Clinica diagnosticul şi tratamentul de recuperare Note de curs Constanţa: Editura Dobrogea.

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