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Herrán de la Gala D, Barba Arce AB, Lamagrande Obregón A, Landeras Álvaro RM, Cobo Ruiz T, Gallardo Agromayor EC. Diffuse idiopathic skeletal hyperostosis: Imaging findings with special focus on extraspinal involvement. RADIOLOGIA 2024; 66:447-458. [PMID: 39426813 DOI: 10.1016/j.rxeng.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/01/2023] [Indexed: 10/21/2024]
Abstract
Diffuse Idiopathic Skeletal Hyperostosis (IDHS) is a multifactorial disease with a high prevalence and that is frequently detected incidentally in imaging tests. Most of its diagnostic criteria are focused on axial involvement and more specifically the spine. However, peripheral involvement in DISH is less well known despite its non insignificant frequency. DISH can be associated with serious complications, the most severe being vertebral fractures in low energy trauma and dysphagia or airway obstruction in cervical involvement. Knowing how to identify the patterns of peripheral involvement of DISH and its complications helps in the radiological and clinical management of patients with this disease.
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Affiliation(s)
- D Herrán de la Gala
- Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain; Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain.
| | - A B Barba Arce
- Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain; Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - A Lamagrande Obregón
- Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain; Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - R M Landeras Álvaro
- Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain; Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - T Cobo Ruiz
- Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain; Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - E C Gallardo Agromayor
- Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain; Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
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Fournier DE, Leung AE, Battié MC, Séguin CA. Prevalence of diffuse idiopathic skeletal hyperostosis (DISH) and early-phase DISH across the lifespan of an American population. Rheumatology (Oxford) 2024; 63:1153-1161. [PMID: 37481711 PMCID: PMC10986808 DOI: 10.1093/rheumatology/kead362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/04/2023] [Indexed: 07/24/2023] Open
Abstract
OBJECTIVES DISH is a common musculoskeletal disorder; however, the imaging features and disease continuum from early to advanced stages is poorly understood. The purpose of this study was to evaluate the prevalence of DISH and early-phase DISH in an American population and to assess the extent and pattern of ectopic mineralization across the thoracic spine. METHODS Data were retrieved in collaboration with the Rochester Epidemiology Project. We conducted a retrospective image evaluation of a sample of individuals over 19 years of age with CT of the thoracic spine from a Northern US catchment area. Stratified random sampling by age and sex was used to populate the study. We examined the prevalence and extent of ectopic mineralization along the thoracic spine using previously established criteria. RESULTS A total of 1536 unique images (766 female and 770 male individuals) including 16 710 motion segments were evaluated for imaging features of the continuum of DISH. Collectively, 40.5% of all motion segments evaluated displayed evidence of ectopic mineralization in the thoracic spine. The prevalence of early-phase DISH was 13.2% (10.4% of female and 15.8% of male individuals). The prevalence of established DISH was 14.2% (7.4% of female and 20.9% of male individuals). Remarkable heterogeneity was detected in individuals within each disease classification, based on the extent of the thoracic spine affected and degree of mineralization. CONCLUSIONS The continuum of imaging features associated with DISH is detected in more than one in four adults and both sexes in an American population.
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Affiliation(s)
- Dale E Fournier
- Health and Rehabilitation Sciences (Physical Therapy), Faculty of Health Sciences,The University of Western Ontario, London, ON, Canada
- Bone and Joint Institute, The University of Western Ontario, London, ON, Canada
| | - Andrew E Leung
- Bone and Joint Institute, The University of Western Ontario, London, ON, Canada
- Department of Medical Imaging, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
| | - Michele C Battié
- Bone and Joint Institute, The University of Western Ontario, London, ON, Canada
- School of Physical Therapy, Faculty of Health Sciences,The University of Western Ontario, London, ON, Canada
| | - Cheryle A Séguin
- Bone and Joint Institute, The University of Western Ontario, London, ON, Canada
- Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
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Appleby J. Ageing and disease risk factors: A new paleoepidemiological methodology for understanding disease in the past. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2024; 44:33-45. [PMID: 38134630 DOI: 10.1016/j.ijpp.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/08/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES To outline a methodology that enables the reconstruction of age-related disease risk in past societies. MATERIALS Modern epidemiological evidence considering risk factors for age-related disease is combined with contextual information about an archaeological society of interest. METHODS Data gathered is used to create a qualitative population-specific risk model for the disease of interest. To provide a case study, a risk model is constructed for Chronic Obstructive Pulmonary Disease (COPD) in the Eastern English Bronze Age. RESULTS This enables the first rigorous approach to reconstructing age-related disease risk in the past. A risk model shows a high degree of COPD risk in the Eastern English Bronze Age, with a major contribution from indoor airborne pollution and agricultural practices. SIGNIFICANCE This represents a significant new approach in human paleopathology, facilitating understanding of the occurrence of a wide variety of diseases in the past, without the need for well-preserved skeletons of identified elderly individuals. LIMITATIONS The risk models generated are, of necessity, qualitative rather than quantitative, since we are unable to calculate the size of risk factors in the past with certainty. SUGGESTIONS FOR FURTHER RESEARCH The methodology could be applied to a wide variety of diseases and for many past societies.
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Affiliation(s)
- Jo Appleby
- School of Archaeology and Ancient History, University of Leicester, University Road, Leicester LE1 7RH, England.
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Li S, Banno T, Hasegawa T, Yamato Y, Yoshida G, Arima H, Oe S, Ide K, Yamada T, Kurosu K, Nakai K, Matsuyama Y. Long-term effects of diffuse idiopathic skeletal hyperostosis on physical function: A longitudinal analysis. J Orthop Sci 2024; 29:109-114. [PMID: 36669955 DOI: 10.1016/j.jos.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Cross-sectional studies on diffuse idiopathic skeletal hyperostosis have focused on its incidence and related factors. However, the long-term changes caused by the disease remain unclear. This longitudinal cohort study aimed to elucidate the progression of diffuse idiopathic skeletal hyperostosis and its effects on physical function, health-related quality of life, and spinal alignment. METHODS We recruited 255 older adults (87 men and 168 women; average age, 71.3 years in 2014) who attended local health checkups in 2014 and 2020. Height, body weight, body mass index, blood pressure, grip strength, functional reach, and bone mineral density were measured. The prevalence, location, number of ossified contiguous vertebrae, and spinopelvic parameters were estimated using whole-spine standing radiographs. For health-related quality of life assessment, the Oswestry disability index and EuroQuol-5D were obtained. We performed a 1:1 case-control study with age and sex-matched patients with and without diffuse idiopathic skeletal hyperostosis and analyzed progression over a 6-year period. RESULTS In 2014, 39 (15.3%) of 255 patients were diagnosed with diffuse idiopathic skeletal hyperostosis (24 males and 15 females), which occurred more frequently in the elderly and males. In 2020, 12 (4.3%) patients were newly diagnosed with diffuse idiopathic skeletal hyperostosis, and 28 (71.7%) of 39 patients diagnosed in 2014 showed varying degrees of progression. Compared with age- and sex-matched patients without diffuse idiopathic skeletal hyperostosis, patients with the condition had higher body mass index and lumbar bone mineral density, larger sagittal vertical axis, and greater T1-pelvic angle. Changes in physical function and spinal-pelvic parameters during the 6-year period did not differ between the groups. CONCLUSIONS Over a 6-year period, the prevalence of diffuse idiopathic skeletal hyperostosis increased by 4.3%, and it progressed in 71.7% of patients. However, it had little effect on longitudinal physical function, health-related quality of life, and spinopelvic parameters in older adults.
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Affiliation(s)
- Shuo Li
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Tomohiro Banno
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
| | - Tomohiko Hasegawa
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yu Yamato
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan; Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka, Japan
| | - Go Yoshida
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Hideyuki Arima
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Shin Oe
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan; Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka, Japan
| | - Koichiro Ide
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Tomohiro Yamada
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Kenta Kurosu
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Keiichi Nakai
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yukihiro Matsuyama
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
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Furukawa M, Fujiyoshi K, Okubo T, Yanai Y, Matsubayashi K, Kato T, Kobayashi Y, Konomi T, Yato Y. Effects of Bone Cross-Link Bridging on Fracture Mechanism and Surgical Outcomes in Elderly Patients with Spine Fractures. Asian Spine J 2023; 17:676-684. [PMID: 37408292 PMCID: PMC10460660 DOI: 10.31616/asj.2022.0319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/14/2022] [Accepted: 11/24/2022] [Indexed: 07/07/2023] Open
Abstract
STUDY DESIGN This study adopted a cross-sectional study design. PURPOSE This study was designed to investigate the effects of bone cross-link bridging on fracture mechanism and surgical outcomes in vertebral fractures using the maximum number of vertebral bodies with bony bridges between adjacent vertebrae without interruption (maxVB). OVERVIEW OF LITERATURE The complex interplay of bone density and bone bridging in the elderly can complicate vertebral fractures, necessitating a better understanding of fracture mechanics. METHODS We examined 242 patients (age >60 years) who underwent surgery for thoracic to lumbar spine fractures from 2010 to 2020. Subsequently, the maxVB was classified into three groups: maxVB (0), maxVB (2-8), and maxVB (9-18), and parameters, including fracture morphology (new Association of Osteosynthesis classification), fracture level, and neurological deficits were compared. In a sub-analysis, 146 patients with thoracolumbar spine fractures were classified into the three aforementioned groups based on the maxVB and compared to determine the optimal operative technique and evaluate surgical outcomes. RESULTS Regarding the fracture morphology, the maxVB (0) group had more A3 and A4 fractures, whereas the maxVB (2-8) group had less A4 and more B1 and B2 fractures. The maxVB (9-18) group exhibited an increased frequency of B3 and C fractures. Regarding the fracture level, the maxVB (0) group tended to have more fractures in the thoracolumbar transition region. Furthermore, the maxVB (2-8) group had a higher fracture frequency in the lumbar spine area, whereas the maxVB (9-18) group had a higher fracture frequency in the thoracic spine area than the maxVB (0) group. The maxVB (9-18) group had fewer preoperative neurological deficits but a higher reoperation rate and postoperative mortality than the other groups. CONCLUSIONS The maxVB was identified as a factor influencing fracture level, fracture type, and preoperative neurological deficits. Thus, understanding the maxVB could help elucidate fracture mechanics and assist in perioperative patient management.
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Affiliation(s)
- Mitsuru Furukawa
- Department of Orthopaedics Surgery, Murayama Medical Center, Tokyo, Japan
| | - Kanehiro Fujiyoshi
- Department of Orthopaedics Surgery, Murayama Medical Center, Tokyo, Japan
| | - Toshiki Okubo
- Department of Orthopaedics Surgery, Murayama Medical Center, Tokyo, Japan
| | - Yoshihide Yanai
- Department of Orthopaedics Surgery, Murayama Medical Center, Tokyo, Japan
| | - Kohei Matsubayashi
- Department of Orthopaedics Surgery, Murayama Medical Center, Tokyo, Japan
| | - Takashi Kato
- Department of Orthopaedics Surgery, Murayama Medical Center, Tokyo, Japan
| | - Yoshiomi Kobayashi
- Department of Orthopaedics Surgery, Murayama Medical Center, Tokyo, Japan
| | - Tsunehiko Konomi
- Department of Orthopaedics Surgery, Murayama Medical Center, Tokyo, Japan
| | - Yoshiyuki Yato
- Department of Orthopaedics Surgery, Murayama Medical Center, Tokyo, Japan
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