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Disseminated idiopathic skeletal hyperostosis: diagnostic criteria and clinical significance
  1. Annette Wessmann, DrMedVet, DipECVN, PGCertAcPrac, FHEA, MRCVS
  1. Pride Veterinary Centre, Riverside Road, Pride Park, Derby DE24 8HX, UK
  1. e-mail: annettewessmann{at}

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DISSEMINATED idiopathic skeletal hyperostosis (DISH) is a systemic disorder of the axial and appendicular skeleton characterised by calcification and ossification in soft tissues, including the spinal ventral longitudinal ligament and sites of attachment of tendons and capsules to bone (Resnick and Niwayama 1976). In the spine, it is classically diagnosed on survey radiographs by ossification of the ventral longitudinal ligament over several segments, causing complete bone fusion of consecutive vertebral segments (Kranenburg and others 2011). It is not a new disease process. It is commonly seen in people, and spinal hyperostosis similar to DISH has been described in dinosaurs, a saber-toothed cat and old rhesus monkeys (Kranenburg and others 2013).

There is continual controversy over the diagnostic criteria for DISH. The three generally accepted diagnostic criteria, suggested by Resnick and Niwayama (1976), are solely ventral vertebral column abnormalities: (1) flowing calcification and ossification along the ventrolateral aspect of at least four contiguous vertebral bodies; (2) preservation of the intervertebral width and absence of extensive radiographic changes of degenerative intervertebral disc disease; (3) absences of articular process ankylosis, sacroiliac joint erosion, sclerosis or intra-articular osseous fusion. Since then, several reports have also identified dorsal vertebral column abnormalities in dogs with DISH. Consequently, Morgan and Stavenborn (1991) proposed …

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