ABSTRACT
Background: Diffuse idiopathic skeletal hyperostosis and spondyloarthritis share similarities in clinical and radiological findings. In this article, we report a case of overlapping of these two hyperostotic diseases followed by an extensive narrative review of the literature focusing on the gray areas in the diagnosis of diffuse idiopathic skeletal hyperostosis. Case description: We report the case of simultaneous diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis in a 57-year-old man. The diagnosis was made after many collegial meetings based on solid radiological arguments. Conclusion: Review of the literature reveals many uncertainties in the diagnosis of diffuse idiopathic skeletal hyperostosis, especially in the radiological evaluation of sacroiliac joints. Diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis frequently overlap in important radiological features leading to diagnostic ambiguity and they can also co-exist in the same patient.
Subject(s)
Hyperostosis, Diffuse Idiopathic Skeletal , Spondylitis, Ankylosing , Male , Humans , Middle Aged , Hyperostosis, Diffuse Idiopathic Skeletal/complications , Hyperostosis, Diffuse Idiopathic Skeletal/diagnostic imaging , Spondylitis, Ankylosing/complications , Spondylitis, Ankylosing/diagnostic imaging , Sacroiliac Joint/diagnostic imaging , RadiographyABSTRACT
The use of iodinated contrast agents (IC) has become common practice nowadays in the daily diagnostic and therapeutic procedures in radiology. Immediate hypersensitivity reactions occurring up to the first hour after injection of IC, can be of serious consequences, occasionally leading to death. This justifies the establishment of a prevention algorithm, including a sharp identification of those at risk and the implementation of premedication with corticosteroids. A history of previous reaction to IC is the major risk factor of a new reaction. Other risk factors include asthma, atopy and cardiomyopathy. The factors that influence the severity of the hypersensitivity allergic reactions are female gender, age, and taking beta blockers or ACE inhibitor drugs.
