Identifying Clinicoradiological Phenotypes in Diffuse Idiopathic Skeletal Hyperostosis: A Cross-Sectional Study
<i>Background and objectives</i>: Diffuse idiopathic skeletal hyperostosis (DISH) is a bone formation disease in which only skeletal signs are considered in classification criteria. The aim of the study was to describe different phenotypes in DISH patients based on clinicoradiological fe...
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MDPI AG
2021-09-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/10/1005 |
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| author | Teresa Clavaguera Patrícia Reyner Maria Buxó Marta Valls Eulàlia Armengol Xavier Juanola |
| author_facet | Teresa Clavaguera Patrícia Reyner Maria Buxó Marta Valls Eulàlia Armengol Xavier Juanola |
| author_sort | Teresa Clavaguera |
| collection | DOAJ |
| description | <i>Background and objectives</i>: Diffuse idiopathic skeletal hyperostosis (DISH) is a bone formation disease in which only skeletal signs are considered in classification criteria. The aim of the study was to describe different phenotypes in DISH patients based on clinicoradiological features. <i>Materials and Methods</i>: We evaluated 97 patients who met the Resnick or modified Utsinger classification criteria for DISH and were diagnosed at our hospital from 2004 to 2015. Patients were stratified into: (a) peripheral pattern (PP)—Resnick criteria not met but presenting ≥3 peripheral enthesopathies; (b) axial pattern (AP)—Resnick criteria met but <3 enthesopathies; and (c) mixed pattern (MP)—Resnick criteria met with ≥3 enthesopathies. Statistical analysis was carried out to identify variables that might predict classification in a given group. <i>Results</i><b>:</b> Fifty-six of the 97 patients included (57.7%) were male and 72.2% fulfilled the Resnick criteria. Applying our classification, 39.7% were stratified as MP, 30.9% as AP and 29.4% as PP. Clinical enthesopathy was reported in 40.2% of patients during the course of the disease. Sixty-eight patients were included in a comparative analysis of variables between DISH patterns. The results showed a predominance of women (<i>p</i> < 0.004), early onset (<i>p</i> < 0.03), hip involvement (<i>p</i> < 0.003) and enthesitis (<i>p</i> < 0.001) as hallmarks of PP. Asymptomatic patients were most frequently observed in AP (28.6%, MP 3.8%, PP 5.0%) while MP was characterized by a more extensive disease. <i>Conclusions</i>: We believe DISH has distinct phenotypes and describe a PP phenotype that is not usually considered. Extravertebral manifestations should be included in the new classification criteria in order to cover the entire spectrum of the disease. |
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| issn | 1010-660X 1648-9144 |
| language | English |
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| publishDate | 2021-09-01 |
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| series | Medicina |
| spelling | doaj.art-f49b3d697b3444c39834f821b6fb0d322023-11-22T19:03:16ZengMDPI AGMedicina1010-660X1648-91442021-09-015710100510.3390/medicina57101005Identifying Clinicoradiological Phenotypes in Diffuse Idiopathic Skeletal Hyperostosis: A Cross-Sectional StudyTeresa Clavaguera0Patrícia Reyner1Maria Buxó2Marta Valls3Eulàlia Armengol4Xavier Juanola5Servei de Reumatologia, Hospitals Universitari Josep Trueta i Hospital, Santa Caterina, 17007 Salt, SpainServei de Reumatologia, Hospitals Universitari Josep Trueta i Hospital, Santa Caterina, 17007 Salt, SpainServei de Biostadística, Institut d’Investigació Biomèdica de Girona (IDIBGI), 17003 Girona, SpainServei de Reumatologia, Hospitals Universitari Josep Trueta i Hospital, Santa Caterina, 17007 Salt, SpainHospital de Palamós, Palamós, 17230 Girona, SpainHospital Universitari de Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain<i>Background and objectives</i>: Diffuse idiopathic skeletal hyperostosis (DISH) is a bone formation disease in which only skeletal signs are considered in classification criteria. The aim of the study was to describe different phenotypes in DISH patients based on clinicoradiological features. <i>Materials and Methods</i>: We evaluated 97 patients who met the Resnick or modified Utsinger classification criteria for DISH and were diagnosed at our hospital from 2004 to 2015. Patients were stratified into: (a) peripheral pattern (PP)—Resnick criteria not met but presenting ≥3 peripheral enthesopathies; (b) axial pattern (AP)—Resnick criteria met but <3 enthesopathies; and (c) mixed pattern (MP)—Resnick criteria met with ≥3 enthesopathies. Statistical analysis was carried out to identify variables that might predict classification in a given group. <i>Results</i><b>:</b> Fifty-six of the 97 patients included (57.7%) were male and 72.2% fulfilled the Resnick criteria. Applying our classification, 39.7% were stratified as MP, 30.9% as AP and 29.4% as PP. Clinical enthesopathy was reported in 40.2% of patients during the course of the disease. Sixty-eight patients were included in a comparative analysis of variables between DISH patterns. The results showed a predominance of women (<i>p</i> < 0.004), early onset (<i>p</i> < 0.03), hip involvement (<i>p</i> < 0.003) and enthesitis (<i>p</i> < 0.001) as hallmarks of PP. Asymptomatic patients were most frequently observed in AP (28.6%, MP 3.8%, PP 5.0%) while MP was characterized by a more extensive disease. <i>Conclusions</i>: We believe DISH has distinct phenotypes and describe a PP phenotype that is not usually considered. Extravertebral manifestations should be included in the new classification criteria in order to cover the entire spectrum of the disease.https://www.mdpi.com/1648-9144/57/10/1005diffuse idiopathic skeletal hyperostosisenthesopathyossificationheterotopicphenotypeankylosing hyperostoses |
| spellingShingle | Teresa Clavaguera Patrícia Reyner Maria Buxó Marta Valls Eulàlia Armengol Xavier Juanola Identifying Clinicoradiological Phenotypes in Diffuse Idiopathic Skeletal Hyperostosis: A Cross-Sectional Study Medicina diffuse idiopathic skeletal hyperostosis enthesopathy ossification heterotopic phenotype ankylosing hyperostoses |
| title | Identifying Clinicoradiological Phenotypes in Diffuse Idiopathic Skeletal Hyperostosis: A Cross-Sectional Study |
| title_full | Identifying Clinicoradiological Phenotypes in Diffuse Idiopathic Skeletal Hyperostosis: A Cross-Sectional Study |
| title_fullStr | Identifying Clinicoradiological Phenotypes in Diffuse Idiopathic Skeletal Hyperostosis: A Cross-Sectional Study |
| title_full_unstemmed | Identifying Clinicoradiological Phenotypes in Diffuse Idiopathic Skeletal Hyperostosis: A Cross-Sectional Study |
| title_short | Identifying Clinicoradiological Phenotypes in Diffuse Idiopathic Skeletal Hyperostosis: A Cross-Sectional Study |
| title_sort | identifying clinicoradiological phenotypes in diffuse idiopathic skeletal hyperostosis a cross sectional study |
| topic | diffuse idiopathic skeletal hyperostosis enthesopathy ossification heterotopic phenotype ankylosing hyperostoses |
| url | https://www.mdpi.com/1648-9144/57/10/1005 |
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