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NYCC MSP > DISH & OPLL (DRAFT) > Flashcards

DISH & OPLL (DRAFT) Flashcards

1
Q

what does DISH stand for and what is another name for DISH?

A

(Diffuse Idiopathic Skeletal Hyperostosis) Forestiere’s disease

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2
Q

what is the etiology of DISH?

A

unknown

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3
Q

What is DISH? how common is it and what’s the main concept?

A
  • VERY common degenerative condition
  • Hypertrophy and Ossification of the ALL
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4
Q

what population does DISH commonly effect?

A

generally > 50yrs
- 25% of men > 50
- 15% of women > 50

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5
Q

What is the buzz term for DISH?

A

flowing hyperostosis of the ALL

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6
Q

what is the diagnostic criteria for DISH?

A

MUST involve 4 or more adjacent segments

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7
Q

what are Enthesophytes?

A
  • bone growth at insertion site of tendon / ligament into bone
    (so in DISH: ossification in the middle of the vertebral bodies)
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8
Q

DISH involves extensive ____ formation

A

enthesophyte

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9
Q

what is an Enthesis?

A

insertion of tendon / ligament into bone

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10
Q

T/F enthesopathy is a normal age related process.

A

TRUE, difference between normal age related vs. DISH enthesopathy

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11
Q

up to 50% of DISH pts will have ____

A

Ossification of the PLL (OPLL)

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12
Q

T/F DISH is more clinically significant that OPLL

A

FALSE, OPLL is more clinically significant b/c central stenosis

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13
Q

what are the clinical features of DISH?

A
  • can be clinically silent
  • stiff, achy back/neck pain
  • association w/ insulin resistance / diabetes mellitus; theory: pituitary disfunction
  • restrict AROM/PROM; from full to ankylosis
  • spinal patho Fx (risk^ due to ankylosis)
  • ^thoracic kyphosis
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14
Q

what can DISH be associated with? why?

A

insulin resistance / diabetes mellitus; theory: pituitary disfunction

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15
Q

what are the radiographic features of DISH?

A
  • flowing ossification of ALL generally starts mid-vertebral body extending out
  • enthesopathies: nuchal bones, achilles + plantar enthesophytes, pelvic enthesophytes
  • cleavage plane
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16
Q

what are nuchal bones?

A

ossification of nuchal ligament

17
Q

what areas of the skeleton are most commonly affected by DISH?

A

lower thoracic MC
- upper lumbar 2nd
- can involve any/all regions of spine

18
Q

how can we differentiate between DISH and seronegative spondyloarthropathies?

A

DISH preserves SI jts and facet jts (inflammatory degeneration likes to involve these jts)

19
Q

what calcification is seen in everyone?

A

thyroid cartilage calcification (non articular hyaline cartilage)

20
Q

are nuchal bones normal?

A

yes, common in older ppl, but increase if have DISH

21
Q

what is another name for OPLL?

A

Japanese Spine Disease (NOT only found in Japanese descent)

22
Q

what is OPLL?

A

degenerative condition involving hyperostosis of the PLL

23
Q

what population is OPLL commonly seen in?

A

> 50yrs

24
Q

how often do pts w/ DISH co-present w/ OPLL?

A

0.5

25
Q

T/F OPLL can be a stand alone condition

A

t

26
Q

what is the etiology of OPLL?

A

idiopathic (like DISH)

27
Q

what is the diagnostic criteria for OPLL?

A

DOES NOT have to involve 4 segments
DOES NOT have to have DISH

28
Q

what areas of the skeleton are most commonly affected by OPLL?

A

cervical MC; can be any region

29
Q

what feature of OPLL makes it ^clinically significant

A

creates central canal stenosis

30
Q

what are the clinical features of OPLL?

A
  • can be clinically silent
  • stiff, achy back/neck pain
  • restrict AROM/PROM
  • SSx of central canal stenosis
  • can lead to myelopathy (myelomalacia)
31
Q

what is Myelomalacia?

A

softening of SC (described as “tapioca pudding/cottage cheese consistency”)

32
Q

what are the radiographic features of OPLL?

A
  • hyperostosis of PLL can be upwards of 5-8mm thick
  • parallels posterior VB margin
  • DOES NOT have to have DISH
33
Q

how are DISH and OPLL different in preferntial location?

A

DISH: lower thoracic MC
OPLL: cervicals MC

NYCC MSP (28 decks)

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