OBJECTIVE: To revise the definition of DISH and suggest a classification that may better represent our current knowledge of this entity allowing earlier diagnosis. METHODS: Seven rheumatologists and an orthopaedic surgeon suggested a list of 63 parameters that might be included in a future classification of DISH. Participants rated their level of agreement with each item, expressed in percentages. In a second session, participants discussed each item again and re-rated all parameters. Thirty items that were granted ≥50% support on average were considered valid for a third round. A questionnaire listing these 30 items was mailed to 39 rheumatologists and orthopaedic surgeons worldwide with a request to answer categorically if they agreed on an item to be included as a criterion for a future classification of DISH. Items were regarded as perfect consensus when at least 95% of the respondents agreed and were regarded as consensus when at least 80% agreed. RESULTS: There was perfect consensus for 2 (6.7%) of the 30 parameters and consensus for another 2 parameters. These items were ossification and bridging osteophytes in each of the three segments of the spine and exuberant bone formation of bone margins. CONCLUSION: At present there is no agreement about the inclusion of extraspinal, constitutional and metabolic manifestations in a new classification of DISH. Investigators with an interest in this condition should be encouraged to restructure the term DISH in an attempt to establish a more sophisticated definition.
OBJECTIVE: To revise the definition of DISH and suggest a classification that may better represent our current knowledge of this entity allowing earlier diagnosis. METHODS: Seven rheumatologists and an orthopaedic surgeon suggested a list of 63 parameters that might be included in a future classification of DISH. Participants rated their level of agreement with each item, expressed in percentages. In a second session, participants discussed each item again and re-rated all parameters. Thirty items that were granted ≥50% support on average were considered valid for a third round. A questionnaire listing these 30 items was mailed to 39 rheumatologists and orthopaedic surgeons worldwide with a request to answer categorically if they agreed on an item to be included as a criterion for a future classification of DISH. Items were regarded as perfect consensus when at least 95% of the respondents agreed and were regarded as consensus when at least 80% agreed. RESULTS: There was perfect consensus for 2 (6.7%) of the 30 parameters and consensus for another 2 parameters. These items were ossification and bridging osteophytes in each of the three segments of the spine and exuberant bone formation of bone margins. CONCLUSION: At present there is no agreement about the inclusion of extraspinal, constitutional and metabolic manifestations in a new classification of DISH. Investigators with an interest in this condition should be encouraged to restructure the term DISH in an attempt to establish a more sophisticated definition.
Authors: Jonneke S Kuperus; Sytse F Oudkerk; Wouter Foppen; Firdaus A Mohamed Hoesein; Willem Paul Gielis; Job Waalwijk; Elizabeth A Regan; David A Lynch; F Cumhur Oner; Pim A de Jong; Jorrit-Jan Verlaan Journal: Radiology Date: 2019-04-02 Impact factor: 11.105
Authors: Stefanie Francesca Pini; Valentina Acosta-Ramón; Marian Tobalina-Segura; Emilio Pariente-Rodrigo; Javier Rueda-Gotor; José Manuel Olmos-Martínez; José Luis Hernández-Hernández Journal: Clin Rheumatol Date: 2018-12-18 Impact factor: 2.980
Authors: Alexander C Egerter; Eric S Kim; Darrin J Lee; Jonathan J Liu; Gilbert Cadena; Ripul R Panchal; Kee D Kim Journal: Global Spine J Date: 2015-02-26