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Diffuse idiopathic skeletal hyperostosis (DISH, Forestier's disease)

Diffuse idiopathic skeletal hyperostosis is a noninflammatory disease occurring most commonly in obese, diabetic males aged greater than 50 years. It is characterized by flowing hyperostosis (bone formation), calcification of the anterior longitudinal ligament of at least four contiguous vertebral bodies, and nonerosive enthesopathies (whiskerings). The disease is not associated with sacroiliitis, apophyseal joint ankylosis, or HLA-B27. The flowing osteophytes in DISH typically occur on the right side of the spine, contralateral to the heart and aorta. On a lateral spine radiograph, a linear area of radiolucency exists between the calcified anterior longitudinal ligament and the anterior surface of the vertebra.


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