Diffuse idiopathic skeletal hyperostosis is a degenerative condition of the thoracic spine in older adults characterized by undulating “osteophytic-like” bone formation along the anterior longitudinal ligament and sometimes the posterior longitudinal ligament, which may lead to partial or complete fusion of adjacent spinal levels.
usually found in people in their 60s and above
extremely rare in people under age 50 yrs
Aetiology
essentially unknown cause
may be related to:
long term mechanical issues
dietary factors
use of some medications (e.g. isotretinoin, etretinate, acitretin and other vitamin A derivatives)
Clinical features
most are asymptomatic
back stiffness in flexion and extension
may cause chronic thoracic back pain which is usually mild and may be worse in the morning
similar calcification and ossification may be seen at peripheral entheseal sites, including the shoulder, iliac crest, ischial tuberosity, trochanters of the hip, tibial tuberosities, patellae, and bones of the hands and/or feet
rarely, large anterior cervical spine osteophytes may affect the oesophagus or the larynx and cause pain, dysphagia or even dyspnea and may cause lung infections