Diffuse idiopathic skeletal hyperostosis. A case report.

Diffuse idiopathic skeletal hyperostosis is a disease of old age, in which there is bony proliferation of spine in ventral and lateral aspects of vertebral body. A 80-years-old male presented to us with features of low back pain radiating along the right lower limb in the posterolateral aspect. After examination and investigations, he was found to have metabolic syndrome, degenerative lumbar disc disease, and his X-Ray and MRI showed diffuse thickening of lumbar vertebrae from L2-S1. This suggested that the patient had diffuse idiopathic skeletal hyperostosis with extraspinal manifestations which coexisted with lumbar degenerative disc disease. This case shows that both diffuse idiopathic skeletal hyperostosis and lumbar degenerative disc disease can coexist. Diffuse idiopathic skeletal hyperostosis should also be kept as a differential diagnosis in chronic low back pain in old age. Neurology Asia 2012; 17(4) : 365 – 368 Address correspondence to: SS Anand, PDT Neurology, Department of neurology, NRS Medical college and Hospital, 138 AJC Bose road, Sealdah, Kolkata, West Bengal, India. Tel: 91 -8100521173, e-mail: [email protected] INTRODUCTION In diffuse idiopathic skeletal hyperostosis (DISH), there is bony proliferation of spine which becomes relatively thick, along the ventral and lateral aspects of the vertebral bodies along with peripheral entheses. Additionally various constitutional metabolic abnormalities have been reported to be associated with DISH in varying degrees. The prevalence of DISH in adults over the age of 50 years is around 25% for men and 15% for women.