Hyperostosis is associated with all except –
Correct Answer: Cushings syndrome
Description: Diffuse idiopathic skeletal hyperostosis (DISH) is a common disorder, affecting 10% of men and 8% of women over the age of 65, and is associated with obesity, hypeension and type 2 diabetes mellitus. It is characterised by florid new bone formation along the anterolateral aspect of at least four contiguous veebral bodies . DISH is distinguished from lumbar spondylosis by the absence of disc space narrowing and marginal veebral body sclerosis, and from ankylosing spondylitis by the absence of sacroiliitis or apophyseal joint fusion. The exact cause is unknown. Mechanical, dietary factors and use of some medications ( vit A derivatives) may be of significance. There is a correlation between these factors but not a cause or effect. The distinctive radiological feature of DISH is the continuous linear calcification along the antero-medial aspect of the thoracic spine. DISH is usually found in people in their 60s and above, and is extremely rare in people in their 30s and 40s. The disease can spread to any joint of the body, affecting the neck, shoulders, ribs, hips, pelvis, knees, ankles, and hands. Although DISH manifests in a similar manner to Ankylosing spondylitis , they are separate diseases. Ankylosing spondylitis is a genetic disease with identifiable marks, tends to sta showing signs in adolescence or young adulthood, is more likely to affect the lumbar spine, and affects organs. DISH has no indication of a genetic link, and does not affect organs other than the lungs, which is only indirect due to the fusion of the rib cage. Long term treatment of acne with vitamin derived retinoids, such as etretinate and acitretin, have been associated with extraspinal hyperostosis Ref - davidson's medicine 23e p1058
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