Enthesopathy of the anterior chest wall joints in patients with diffuse idiopathic skeletal hyperostosis (DISH): a retrospective analysis of computed tomography scans

  • Shani Broitman
  • Amir Herman
  • Myriam Stern
  • Merav Lidar
  • Iris EshedEmail author
Scientific Article



To evaluate and characterize anterior chest wall (ACW) joint’s enthesopathy on CT scans in patients with DISH compared with age- and gender-matched control group.

Material and methods

Retrospective evaluation for enthesopathy features of ACW joints—sterno-clavicular (SCJ), manubrio-sternal (MSJ), costo-sternal 1–7 (CSJ)—on chest CT scans of subjects with DISH (Resnick criteria) and of age- and gender-matched control subjects was performed. 183 subjects (DISH: 92, control: 91); male:female: 126:57, average age: 71.7 years (range 50–94) were evaluated. Total enthesopathy scores per subjects and per each joint were compared.


Total enthesopathy score of ACW joints was significantly higher among DISH compared to controls (64.03 ± 15.1, 50.47 ± 12.4, p < 0.001). At joint level, SCJ and CSJ enthesopathy, but not MSJ was significantly more prevalent in DISH compared to controls.


ACW joints’ enthesopathy as seen on CT scans, an entity not included in the Resnick classification criteria, is common among DISH subjects. The difference between SCJ and CSJ prevalence compared to MSJ may result from different joint type. ACW joints’ enthesopathy may be considered to be included in future modified radiographic criteria for DISH.


DISH Imaging CT Enthesopathy Anterior chest wall joints 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© ISS 2019

Authors and Affiliations

  1. 1.Department of Diagnostic Imaging, Sheba Medical Center, affiliated to the Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  2. 2.Department of Orthopedic SurgeryAssuta Ashdod Medical Center, Ashdod, affiliated to Ben Gurion UniversityBeer ShevaIsrael
  3. 3.Rheumatology Unit, Sheba Medical Center, affiliated to the Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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