What are the Utsinger 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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Criteria suggested by Julkunen and colleagues are substantially the same as those from Resnick and Niwayama, but also include the presence of bridges connecting two vertebral bodies in at least two sites on the thoracic spine. [34] Utsinger criteria are as follows:

  • Definite DISH: Bridging of four contiguous vertebral bodies, primarily in the thoracolumbar spine, minimal intervertebral disk disease, and no facet joint ankylosis
  • Probable DISH: Bridging of two contiguous vertebral bodies plus bilateral patellar tufting, heel spurring, and olecranon tufting.
  • Possible DISH: Two vertebrae joined in the absence of extraspinal enthesophytes, or symmetrical extraspinal enthesophytes in the absence of spinal involvement

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