Presentation
Fall.
Patient Data
There is thick cortical 'whiskering' enthesopathy of bilateral ASIS, ischial tuberosities, lesser trochanters and right greater trochanter. There are also overgrown osteophytes of the acetabuli, which would predisposed to 'pincer' type femoro-acetabular impingement. The sacroiliac joints and pubic symphysis are normal. The lower lumbar spine demonstrates large thick osteophytes.
These findings are in keeping with diffuse idiopathic skeletal hyperostosis (DISH).
Case Discussion
Diffuse Idiopathic skeletal hyperostosis (DISH) is a bone-forming spinal disease, with ossification of tendons and ligaments. There are however several extraspinal manifestations and in the pelvis there may be hyperostosis at ligamentous attachments as seen in this case.
This patient had known DISH from previous spinal radiographs.
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