title: CT Abnormalities in the Sacroiliac Joints of Patients With Diffuse Idiopathic Skeletal Hyperostosis.
abstract: OBJECTIVE
  The purpose of this study is to characterize sacroiliac joints (SIJs) findings at CT of patients with diffuse idiopathic skeletal hyperostosis (DISH), a condition characterized (using the Resnick classification criteria) by ossification of at least four contiguous vertebrae in the thoracic spine and preserved disk space, but without radiographic evidence of intraarticular SIJ abnormalities.
  
  
  METHODS
  Pelvic CT examinations of 104 patients with DISH (fulfilling the Resnick criteria on spinal CT) and 106 age- and sex-matched control subjects whose entire spine lacked CT evidence of DISH (total, 149 men and 61 women; mean [± SD] age, 72.3 ± 8.7 years) were retrospectively evaluated for the presence of intra- and extraarticular bridging osteophytes, spurs, subchondral cystlike changes, erosions, and sclerosis of SIJs. Excluded were patients with known ankylosing spondylitis or inflammatory-related diseases. Data were analyzed using multivariate ANOVA to examine the degree of difference between patients with DISH and control subjects. Logistic regression analysis was used to generate odds ratios to examine their discriminatory ability. ROC analysis was then applied to examine the sensitivity and specificity of the results.
  
  
  RESULTS
  The frequency of anterior bridging, posterior bridging, entheseal bridging, and joint ankylosis was significantly higher among patients with DISH compared with control subjects (48% vs 9%, 20% vs 1%, 34% vs 4%, and 23% vs 0%, respectively; p < 0.001 for all comparisons).
  
  
  CONCLUSIONS
  Intraarticular ankylosis seen at CT, an entity not included in the Resnick classification criteria, is common among patients with DISH, which implies that the radiologic classification criteria for DISH need to be revised.
authors.affiliation: 1 Rheumatology Unit, Sheba Medical Center, Tel Hashomer, affiliated to the Sackler School of Medicine, Tel Aviv, Israel.
authors.forename: Naama
authors.initials: N
authors.lastname: Leibushor
authors.affiliation: 2 Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, affiliated to the Sackler School of Medicine, Tel Aviv 52621, Israel.
authors.forename: Einat
authors.initials: E
authors.lastname: Slonimsky
authors.affiliation: 2 Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, affiliated to the Sackler School of Medicine, Tel Aviv 52621, Israel.
authors.forename: Dvora
authors.initials: D
authors.lastname: Aharoni
authors.affiliation: 1 Rheumatology Unit, Sheba Medical Center, Tel Hashomer, affiliated to the Sackler School of Medicine, Tel Aviv, Israel.
authors.forename: Merav
authors.initials: M
authors.lastname: Lidar
authors.affiliation: 2 Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, affiliated to the Sackler School of Medicine, Tel Aviv 52621, Israel.
authors.forename: Iris
authors.initials: I
authors.lastname: Eshed
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D004057:Hyperostosis, Diffuse Idiopathic Skeletal / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D055009:Spondylosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: CT; Resnick classification criteria; ankylosis; diffuse idiopathic skeletal hyperostosis; sacroiliac joints