Differentiation of diffuse idiopathic skeletal hyperostosis (DISH) with back pain from back pain without DISH-clinical hints.

Objectives: Diffuse idiopathic skeletal hyperostosis (DISH) is characterised by an exuberant new bone formation involving the entire skeleton and predominantly the spine. Clinical manifestations and symptoms that differentiate DISH from other chronic noninflammatory musculoskeletal diseases are still not well-described. This study aimed to compare the clinical presentation of patients diagnosed with back pain and the diagnosis of DISH vs those without DISH. Methods: Data on demographics, musculoskeletal symptoms and clinical examinations were retrieved from a database of 92 clinically symptomatic patients previously diagnosed with DISH and 41 patients with back pain, without concomitant DISH (non-DISH group). Differences between those measures were analysed. Results: Sex and age distributions were comparable between patients DISH and non-DISH. Chest expansion (CE) was smaller in DISH vs non-DISH (2.1 ± 1.2 cm vs 3.3 ± 1.3 cm, Conclusions: In comparison to non-DISH patients with back pain, the combination of high BMI, type 2 diabetes mellitus, small CE and high OW are highly suggestive for DISH patients symptomatic for back pain. Future studies of these measures are warranted in larger cohorts of patients and with DISH patients in various levels of evolvement.