Friday, February 10, 2012

Diffuse Idiopathic Skeletal Hyperostosis: Pelvis

We're all familiar with the spinal findings of diffuse idiopathic skeletal hyperostosis (DISH). Radiographic manifestations in the pelvis are usually symmetrical and include:
  • Enthesophytes (yellow arrows): Irregular outgrowths or whiskering seen most commonly at the iliac crests, ischial tuberosities, and the trochanters.
  • Para-articular osteophytes (red arrows): Broad and well-defined. Seen at the acetabular margins, sacroiliac joints, and pubic symphysis. Sacroiliac osteophytes tend to affect the inferior margins.
  • Ligamentous ossification: Iliolumbar (black arrows) and sacrotuberous ligaments.

References

  • Resnick D, Shaul SR, Robins JM. Diffuse idiopathic skeletal hyperostosis (DISH): Forestier's disease with extraspinal manifestations. Radiology. 1975 Jun;115(3):513-24.

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