What are the Resnick and Niwayama diagnostic criteria for diffuse idiopathic skeletal hyperostosis (DISH)?

Updated: Oct 23, 2018
  • Author: Bruce M Rothschild, MD; Chief Editor: Jeffrey D Thomson, MD  more...
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The most commonly used diagnostic criteria for DISH are those set by Resnick and Niwayama, which are as follows [32, 33] :

  • Calcification and ossification along the ventrolateral aspects of at least four contiguous vertebral bodies, with or without localized pointed excrescences at intervening vertebral body–disk junctions
  • Relative preservation of intervertebral disc height in the involved areas, with absence of extensive radiographic changes of degenerative disc disease (intervertebral osteochondrosis), including vacuum phenomena and vertebral body marginal sclerosis
  • Absence of apophyseal joint bony ankylosis and sacroiliac joint erosion, sclerosis, or intra-articular bony fusion

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