TY - JOUR
T1 - Diffuse Idiopathic Skeletal Hyperostosis, Associated Morbidity, and Healthcare Utilization
T2 - A University Hospital Experience
AU - Tripathi, Maanas
AU - Rajmohan, Divya
AU - Quirk, Cody
AU - Beckett, Brooke
AU - Choi, Dongseok
AU - Rich-Garg, Neha
AU - Deodhar, Atul
N1 - Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Background Diffuse idiopathic skeletal hyperostosis (DISH) is a noninflammatory condition affecting the spine, characterized by ossification of paravertebral ligaments. Our cross-sectional study investigated the frequency, associated morbidity, and healthcare utilization of DISH patients at our university hospital over 1 year. Methods Our university's database of spinal radiographs was searched from 2005 to 2015 for "DISH"or "diffuse idiopathic skeletal hyperostosis."The diagnosis of DISH was made by 2 board-certified radiologists (B.B. and C.Q.) based on the radiographs of cervical, thoracic, or lumbar spine. Patients from 2015 were further analyzed with regards to demographics, comorbidities, and healthcare interventions. Their spinal radiographs were reread by 2 authors. Patients were divided into those who fulfilled the Resnick criteria for DISH (group A), and those who did not fully meet the criteria but had radiographic features suggestive of DISH (group B). Means and proportions were used to describe variables. For group comparisons, t test and χ2 test were used. Results Between 2005 and 2015, 3439 radiology records mentioned DISH as a diagnosis. Of 195 patients diagnosed with DISH in 2015, 153 were in group A, 41 were in group B, and 2 had erroneous diagnoses. Chronic back pain was common, and more often reported in group B than in group A (81% vs 63%, p = 0.04). Substantial portions of patients required opioid medications for pain control (51%), spinal surgery (31%), and consultations with various specialists for regional pain (57%). Conclusions Diffuse idiopathic skeletal hyperostosis is a diagnosis with significant morbidity, despite being commonly viewed as asymptomatic. A majority of DISH patients had chronic back pain, and a large proportion required spinal surgery, although there may be several confounders. Future research is needed to systematically assess healthcare utilization by DISH patients.
AB - Background Diffuse idiopathic skeletal hyperostosis (DISH) is a noninflammatory condition affecting the spine, characterized by ossification of paravertebral ligaments. Our cross-sectional study investigated the frequency, associated morbidity, and healthcare utilization of DISH patients at our university hospital over 1 year. Methods Our university's database of spinal radiographs was searched from 2005 to 2015 for "DISH"or "diffuse idiopathic skeletal hyperostosis."The diagnosis of DISH was made by 2 board-certified radiologists (B.B. and C.Q.) based on the radiographs of cervical, thoracic, or lumbar spine. Patients from 2015 were further analyzed with regards to demographics, comorbidities, and healthcare interventions. Their spinal radiographs were reread by 2 authors. Patients were divided into those who fulfilled the Resnick criteria for DISH (group A), and those who did not fully meet the criteria but had radiographic features suggestive of DISH (group B). Means and proportions were used to describe variables. For group comparisons, t test and χ2 test were used. Results Between 2005 and 2015, 3439 radiology records mentioned DISH as a diagnosis. Of 195 patients diagnosed with DISH in 2015, 153 were in group A, 41 were in group B, and 2 had erroneous diagnoses. Chronic back pain was common, and more often reported in group B than in group A (81% vs 63%, p = 0.04). Substantial portions of patients required opioid medications for pain control (51%), spinal surgery (31%), and consultations with various specialists for regional pain (57%). Conclusions Diffuse idiopathic skeletal hyperostosis is a diagnosis with significant morbidity, despite being commonly viewed as asymptomatic. A majority of DISH patients had chronic back pain, and a large proportion required spinal surgery, although there may be several confounders. Future research is needed to systematically assess healthcare utilization by DISH patients.
KW - comorbidity
KW - cross-sectional study
KW - epidemiology
KW - hyperostosis
KW - pathology
KW - prevalence
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U2 - 10.1097/RHU.0000000000000965
DO - 10.1097/RHU.0000000000000965
M3 - Article
C2 - 30585993
AN - SCOPUS:85082561614
SN - 1076-1608
VL - 26
SP - 104
EP - 108
JO - Journal of Clinical Rheumatology
JF - Journal of Clinical Rheumatology
IS - 3
ER -