The Prevalence and Clinical Features of Diffuse Idiopathic Skeletal Hyperostosis in the Patients with Dorsal Back Pain

ABSTRACT

OBJECTIVE: To investigate the prevalence and clinical features of diffuse idiopathic skeletal hyperostosis (DISH) in patients with dorsal back pain. METHOD: A total of 229 patients (119 men and 110 women) with dorsal back pain were included. Medical records including age, sex, chief complaints, medical history, physical findings, laboratory data, and musculoskeletal radiographs were reviewed retrospectively. RESULTS: Twenty-seven (11.8%, by Resnick's criteria) and thirty-eight (16.6%, by Julkunen's criteria) of the 229 patients were diagnosed with DISH by thoracic spine radiographs. A significant increase of risk with age was observed (Resnick's criteria odds ratio 1.10, 95% CI 1.05~1.16, p< 0.001, Julkunen's criteria odds ratio 1.08, 95% CI 1.04~1.12, p<0.001). Male sex (Resnick's criteria odds ratio 2.65, 95% CI 1.01~6.95, p=0.048, Julkunen's criteria odds ratio 2.87, 95% CI 1.27~6.59, p=0.011) and inflammatory pain (Resnick's criteria odds ratio 7.76, 95% CI 2.69~22.33, p<0.001, Julkunen's criteria odds ratio 3.84, 95% CI 1.55~9.47, p=0.004) showed higher risk for development of DISH. Mean body mass index of patients with DISH were higher in all age groups, and they showed higher prevalence of DM and hyperlipidemia than general population. CONCLUSION: Patients with dorsal back pain showed higher prevalence of DISH than previous results with random samples. Aging, male sex and inflammatory pain might be a risk factor for development of DISH. Also, obesity, DM and hyperlipidemia might be strongly related with DISH.