Abstract
The prevalence of hyperostotic spurs (HS) in different areas of the shoulder was studied in 36 probands with and 58 probands without thoracospinal hyperostosis on lateral chest radiographs. Bilateral shoulder radiographs in three projections were analysed blindly, recording the presence of HS at six separate sites (glenoid, greater tuberculum, acromion, acromioclavicular joint, coracoid and humeral shaft) and applying defined grading criteria. The prevalence of HS ranged from 11.7% of the shoulders at the coracoid to 50.0% at the glenoid. The prevalence of HS was similar on both sides [right, 30.1% of the sites versus left, 27.0%, relative risk (RR) 1.12 (95% confidence interval {Cl} 0.93–1.35)] and was not related to sex and history of work. Classification for the presence of shoulder hyperostosis was identical on both sides with the exception of one individul. In probands with thoracospinal and shoulder hyperostosis all areas analysed contributed to the classification. However, this was particularly prominent at the humeral shaft [RR 5.3 (95% Cl 2.1–13.0)] and the coracoid [RR 8.4 (95% Cl 1.9–36.4)]. These results indicated that the prevalence of HS and the specificity for the presence of diffuse idiopathic skeletal hyperostosis (DISH) vary between different sites. We suggest that future grading criteria for shoulder hyperostosis take into account the localization of HS, in addition to their number and size.
Similar content being viewed by others
References
Resnick D, Shapiro RF, Wiesner KB, Niwayama G, Utsinger PD, Shaul SR (1978) Diffuse idiopathic skeletal hyperostosis (DISH). Semin Arthritis Rheum 7:153–187
Utsinger PD (1985) Diffuse idiopathic skeletal hyperostosis. Clin Rheum Dis 11:325–351
Arlet J, Mazières B (1985) La maladie hyperostosique. Rev Med Interne 6:553–564
Resnick D, Shaul SR, Robins JM (1975) Diffuse idiopathic skeletal hyperostosis (DISH): Forestier's disease with extraspinal manifestations. Radiology 115:513–524
Utsinger PD, Resnick D, Shapiro R (1976) Diffuse skeletal abnormalities in Forestier's disease. Arch Intern Med 139:763–768
Dirheimer Y, Borges D'Almeida MT, Christmann D, Ramsheyi A (1981) Aspects specifiques et non-specifiques des atteintes radiologiques extra-spinales de l'hyperostose vertebrale. Rhumatologie 23:369–372
Fournie B, Railhac JJ, Ayrolles C, Fournie A (1984) L'épaule hyperostosique. Rev Rhum Mal Osteoartic 51:389–392
elGarf AE, Khater R (1984) Diffuse idiopathic skeletal hyperostosis (DISH), a clinicoradiological study of the disease pattern in a middle eastern population. J Rheumatol 11:804–807
Fournie B, Railhac JJ, Monod P, Valverde C, Barbe JJ, Fournie A (1987) Lepaule enthésiopathique. Rev Rhum Mal Osteoartic 54:447–451
Beyeler Ch, Schlapbach P, Gerber NJ, Sturzenegger J, Fahrer H, van der Linden S, Buergi U, Fuchs WA, Ehrengruber H (1990) Diffuse idiopathic skeletal hyperostosis (DISH) of the shoulder: a cause of shoulder pain? Br J Rheumatol 29:349–353
Mathieu P, Beaume T, Conrozier T, Vignon E (1990) Incidence of vertebral hyperostosis in patients with calcified tendinitis of the shoulder. Prospective study. Rev Rhum Mal Osteoartic 57:177–180
Schlapbach P, Beyeler Ch, Gerber NJ, van der Linden SM, Buergi U, Fuchs WA, Ehrengruber H (1989) Diffuse idiopathic skeletal hyperostosis (DISH) of the spine: a cause of back pain? A controlled study. Br J Rheumatol 28:299–303
Resnick D, Niwayama G (1975) Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis. Radiology 119:559–568
Hukuda S, Mochizuki T, Ogata M, Shichikawa K (1983) The pattern of spinal and extraspinal hyperostosis in patients with ossification of the posterior longitudinal ligament and the ligamentum flavum causing myelopathy. Skeletal Radiol 10:79–85
Di Giovanna JJ, Helfgoth RK, Gerber LH, Peck GL (1986) Extraspinal tendon and ligament calcification associated with long term therapy with etretinate. N Engl J Med 315:1177–1182
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Beyeler, C., Lehmann, L., Schlapbach, P. et al. Diffuse idiopathic skeletal hyperostosis (DISH) of the shoulder. Rheumatol Int 15, 107–110 (1995). https://doi.org/10.1007/BF00302126
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00302126