Not so Mutually Exclusive Diseases: A Case of Co-occurrence of Inflammatory Spondyloarthritis and Diffuse Skeletal Hyperostosis in a Young Patient

Keywords

Diffuse idiopathic skeletal hyperostosis, DISH, ankylosing spondylitis, spondyloarthritis, SpA

Abstract

Diffuse idiopathic skeletal hyperostosis (DISH) and axial spondyloarthritis (axial SpA) are differential diagnoses of lower back pain. While the latter is considered to be an inflammatory disease, DISH is thought to be a metabolic condition. The authors report a case of a 34-year-old man who presented with a one-year history of axial lower back pain associated to migratory polyarthritis, buttock and heel pain. Imaging revealed contiguous calcification of the anterior longitudinal ligament of the cervical segment, meeting major criteria for DISH. However, he also exhibited signs of bilateral sacroiliitis highly suggestive of axial SpA for which he initiated biological therapy.

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References

  • Mader R, Pappone N, Baraliakos X, Eshed I, Sarzi-Puttini P, Atzeni F, et al. Diffuse idiopathic skeletal hyperostosis (DISH) and a possible inflammatory component. Curr Rheumatol Rep. 2021;23:6.
  • Kuperus JS, Waalwijk JF, Regan EA, van der Horst-Bruinsma, Cumhur Oner F, de Jong PA, et al. Simultaneous occurrence of ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis: A systematic review. Rheumatology (Oxford). 2018;57:2120-2128.
  • Mader R, Verlaan J-J, Eshed I, Bruges-Armas J, Sarzi Puttini P, Atzeni F, et al. Diffuse idiopathic skeletal hyperostosis (DISH): Where are we now and where to go next. RMD Open. 2017;3:e000472.
  • Quintero-Gonzalez DC, Arbeláez-Cortés Á, Rueda JM. Clinical and radiological characteristics of diffuse idiopathic skeletal hyperostosis in two medical centers in Cali, Colombia: Report of 24 cases. Rev Colomb Reumatol 2020;27:80–87.
  • Ritchlin C, Adamopoulos IE. Axial spondyloarthritis: New advances in diagnosis and management. BMJ 2021;372:m4447.
  • Navarro-Compán V, Sepriano A, El-Zorkany B, van der Heijde D. Axial spondyloarthritis. Ann Rheum Dis. 2021;80:1511-1521.
  • Kozanoglu E, Guzel R, Guler-Uysal F, Goncu K. Coexistence of diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis: A case report. Clin Rhematol. 2002;21:258-260.
  • Latourte A, Charlon S, Etcheto A, Feydy A, Allanore Y, Dougados M, et al. Imaging findings suggestive of axial spondyloarthritis in diffuse idiopathic skeletal hyperostosis. Arthritis Care Res (Holboken). 2018;70:145-152.
  • Betsinger TK, Scott AB. Back-to-back: The co-occurrence of DISH and ankylosing spondylitis from early modern Poland. Int J Paleopathol. 2022;40:1-6.
  • DiGiovanna JJ. Isotretinoin effects on bone. J Am Acad Dermatol. 2001;45:S176-S182.
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    Published: 2023-02-03
    Issue: 2023: Vol 10 No 1 (view)


    How to cite:
    1.
    Taborda F, Ferreira DA, Mendonça T, Farinha F. Not so Mutually Exclusive Diseases: A Case of Co-occurrence of Inflammatory Spondyloarthritis and Diffuse Skeletal Hyperostosis in a Young Patient. EJCRIM 2023;10 doi:10.12890/2023_003721.