To determine whether you have DISH, your doctor may begin with a physical examination of your spine and joints. He or she will press lightly on your spine and joints to feel for abnormalities. Any pain you experience from the pressure on your spine may be a clue to the diagnosis. DISH may cause pain at the point where the affected tendon or ligament attaches to a bone. Your doctor may be able to detect bone spurs.
Your doctor also will order imaging tests to help with the diagnosis. Tests that may be used include:
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X-rays. Your doctor will order X-rays to confirm a diagnosis of diffuse idiopathic skeletal hyperostosis.
X-rays may show calcification along the bones that make up your spine. The calcification has a distinct appearance that doctors sometimes refer to as cascading or flowing. Some compare the appearance to that of candle wax dripping and oozing down your spine.
- Computerized tomography (CT) and magnetic resonance imaging (MRI). These tests can rule out conditions that may cause similar signs and symptoms, such as ankylosing spondylitis.
- Fierstein GS, et al. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/das/book/body/194678336-3/982047756/1807/375.html#4-u1.0-B978-1-4160-3285-4..10053-1--s1130_1650. Accessed Aug. 31, 2012.
- Browner BD. Skeletal Trauma. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4160-2220-6..X1000-6&isbn=978-1-4160-2220-6&uniqId=357104634-4#4-u1.0-B978-1-4160-2220-6..X1000-6-TOP. Accessed Aug. 31, 2012.
- Imboden JB, et al. Current Rheumatology Diagnosis & Treatment. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2007. http://www.accessmedicine.com/content.aspx?aID=2728875. Accessed Aug. 31, 2012.
- Taljanovic MS, et al. Imaging characteristics of diffuse idiopathic skeletal hyperstosis with an emphasis on acute spinal fractures: Review. American Journal of Roentgenology. 2009;193:S10.
- Westerveld LA, et al. Spinal fractures in patients with ankylosing spinal disorders: A systematic review of the literature on treatment, neurological status and complications. European Spine Journal. 2009;18:145.
- Mader R, et al. Extraspinal manifestations of diffuse idiopathic skeletal hyperostosis. Rheumatology. 2009;48:1478.
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