Background/Purpose

to investigate musculoskeletal ultrasound (MSUS) as a diagnostic modality in DISH and to explore if it might help in elucidating its pathogenesis and events that precede the calcification/ossification process.

Methods Fifty patients with DISH and 34 patients with osteoarthritis of the lower limbs without DISH were investigated. Data regarding demographics and traditional cardiovascular risk factors was collected from all patients. An ultrasonography was performed according to the Glasgow Ultrasound Enthesitis Scoring System (GUESS) by observers who were blinded to the diagnosis or the clinical findings in the patients.

Results

The total mean GUESS score for patients with DISH was 14.12 ±5.2 and for patients without DISH 5.32 ±4.99 (p<0.0001). Univariate logistic regression analysis found a strong association between the GUESS and the probability of having DISH (p<0.0001). The area under the ROC curve (AUC) revealed that the GUESS accuracy in diagnosing DISH was 88.53% with sensitivity and specificity of 92% and 70.6% respectively, at a cutoff value of 6.36. A stepwise logistic regression analysis of the statistically significant items in the GUESS, isolated 4 items, the presence of either all of them or, the first 3 items yielded the likelihood of having DISH to be 98.8%, and 90.6% respectively

Conclusion

The GUESS and the stepwise logistic regression analysis demonstrated a high likelihood of having DISH. MSUS might shed light on the early entheseal changes in DISH, and the temporal relationship between the spinal and peripheral involvement in this condition. Further studies are needed to confirm these results.

---

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/can-ultrasonography-of-peripheral-entheses-play-a-role-in-the-diagnosis-and-understanding-of-diffuse-idiopathic-skeletal-hyperostosis-dish/