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Diffuse Idiopathic Skeletal Hyperostosis Manifesting as Recurrent Elbow Bursitis
MEDICAL IMAGES
RUNNING HEAD
Diffuse Idiopathic Skeletal Hyperostosis Manifesting as Recurrent Elbow Bursitis Jules Gregory, BS,* and Ines Colmegna, MD† 6OJWFSTJUÊ1BSJT%FTDBSUFT 1BSJT 'SBODF BOEn%JWJTJPOPG3IFVNBUPMPHZ .D(JMM6OJWFSTJUZ .POUSFBM 2VFCFD $BOBEB
A
58-year-old man presented with a several-year history of neck stiffness and recurrent episodes of left elbow and heel pain. Radiography revealed a “bony shield” involving the anterior longitudinal ligaments from C3 to C7 (Figure, A, arrow) and a “flowing” ossification along the anterolateral margins of T6 to T10, resulting in a “bumpy spinal contour” (Figure B, arrows). These radiographic changes are characteristic of diffuse idiopathic skeletal hyperostosis, a noninflammatory disease characterized by thickening, cal-
702
cification, and/or ossification of ligaments and enthesis. Large symmetrical ossified enthesophytes involving the olecranon (Figure, C, arrow) and the plantar (Figure, D, arrowhead) and posterior aspects (Figure, D, arrow) of the calcaneus are common findings in diffuse idiopathic skeletal hyperostosis. Often asymptomatic, enthesophytes can be associated with recurrent episodes of bursitis or tendonitis. © 2011 Mayo Foundation for Medical Education and Research
.BZP$MJO1SPDr+VMZ rEPJNDQrXXXNBZPDMJOJDQSPDFFEJOHTDPN
For personal use. Mass reproduce only with permission from Mayo a Clinic Proceedings.
RUNNING HEAD
Diffuse Idiopathic Skeletal Hyperostosis Manifesting as Recurrent Elbow Bursitis Jules Gregory, BS,* and Ines Colmegna, MD† 6OJWFSTJUÊ1BSJT%FTDBSUFT 1BSJT 'SBODF BOEn%JWJTJPOPG3IFVNBUPMPHZ .D(JMM6OJWFSTJUZ .POUSFBM 2VFCFD $BOBEB
A
58-year-old man presented with a several-year history of neck stiffness and recurrent episodes of left elbow and heel pain. Radiography revealed a “bony shield” involving the anterior longitudinal ligaments from C3 to C7 (Figure, A, arrow) and a “flowing” ossification along the anterolateral margins of T6 to T10, resulting in a “bumpy spinal contour” (Figure B, arrows). These radiographic changes are characteristic of diffuse idiopathic skeletal hyperostosis, a noninflammatory disease characterized by thickening, cal-
702
cification, and/or ossification of ligaments and enthesis. Large symmetrical ossified enthesophytes involving the olecranon (Figure, C, arrow) and the plantar (Figure, D, arrowhead) and posterior aspects (Figure, D, arrow) of the calcaneus are common findings in diffuse idiopathic skeletal hyperostosis. Often asymptomatic, enthesophytes can be associated with recurrent episodes of bursitis or tendonitis. © 2011 Mayo Foundation for Medical Education and Research
.BZP$MJO1SPDr+VMZ rEPJNDQrXXXNBZPDMJOJDQSPDFFEJOHTDPN
For personal use. Mass reproduce only with permission from Mayo a Clinic Proceedings.