TY - JOUR T1 - Spondyloarthritis and Diffuse Idiopathic Skeletal Hyperostosis: Two Different Diseases That Continue to Intersect JF - The Journal of Rheumatology JO - J Rheumatol SP - 1251 LP - 1253 DO - 10.3899/jrheum.130647 VL - 40 IS - 8 AU - IGNAZIO OLIVIERI AU - SALVATORE D’ANGELO AU - CARLO PALAZZI AU - ANGELA PADULA Y1 - 2013/08/01 UR - http://www.jrheum.org/content/40/8/1251.abstract N2 - Spondyloarthritis (SpA) and diffuse idiopathic skeletal hyperostosis (DISH) are different diseases obliged to converge1.SpA is an inflammatory disease involving the axial skeleton and the peripheral entheses and joints and showing a wide clinical spectrum that encompasses ankylosing spondylitis (AS), reactive arthritis (ReA), psoriatic arthritis (PsA), arthritis related to inflammatory bowel disease (IBD), and forms that do not meet established criteria for these definite categories and are designated as undifferentiated SpA (uSpA)2,3. Recently, classification criteria have been suggested by ASAS (Assessment in Spondyloarthritis International Society) for axial and peripheral SpA4,5. In contrast, DISH is a degenerative condition characterized by calcification and ossification of ligaments and entheseal sites in the axial and the peripheral skeleton6. Classification criteria for DISH used so far require involvement of the spine6 although extravertebral bone proliferations are frequent and characteristic and may precede axial changes7,8. An international study for the development of new criteria is in progress8.At the beginning of the story, AS and DISH resembled each other only on radiographs because of the bony outgrowths they produce in the spine1. Clinically, they were considered very different diseases. Symptoms of AS begin at a young age, frequently in second and third decades, and consist of inflammatory back pain and buttock pain, reduced spinal movement, and progressive typical postural abnormalities known as “Bechterew stoop.” In contrast, DISH was considered a disease with an asymptomatic course or with mild dorsolumbar pain and/or some restriction of spinal motion.Radiographically, DISH is characterized by “flowing mantles” of ossifications occurring in the anterior longitudinal … Address correspondence to Dr. Olivieri, Rheumatology Department of Lucania-San Carlo Hospital, Contrada Macchia Romana, 85100-Potenza, Italy. E-mail: ignazioolivieri{at}tiscalinet.it ER -