Dystrophic calcification and heterotopic ossification in fibrocartilaginous tissues of the spine in

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INTRODUCTIONrnDiffuse idiopathic skeletal hyperostosis (DISH) is a noninflamma-tory spondyloarthropathy characterized by bony outgrowths or hyperostoses along the anterolateral aspect of the vertebral column, particularly in the thoracic region.1 DISH is diagnosed by the radiographic detection of flowing mineral formation along four contiguous vertebral bodies, the preservation of interverteb-ral disc (IVD) height in the involved areas, and the absence of bony ankylosis of the vertebral facet and/or sacroiliac joints.2 Although not included in the diagnostic criteria, DISH is often associated with the presence of extraspinal hyperostoses, commonly in the knee, ankle, hip, shoulder, and elbow joints.3 Symptoms asso-ciated with DISH are variable, ranging from spine stiffness and decreased spinal ranges of motion (with or without back pain) to, in severe cases, dysphagia, spinal cord/nerve root compression, and vertebral fracture.
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