In this engaging lecture, Prof. Iris Eshed explores Diffuse Idiopathic Skeletal Hyperostosis (DISH), highlighting that it is far more than just spinal bony bridges. She delves into the imaging hallmarks of DISH, its relationship with metabolic syndrome, and its clinical implications such as dysphagia, fractures after minor trauma, and pelvic enthesopathy. The talk emphasizes how DISH overlaps with, and differs from, spondyloarthritis and degenerative changes, offering practical tips for accurate diagnosis through X-ray, CT, and MRI. Prof. Eshed also discusses underrecognized features, such as Eagle syndrome and sacroiliac joint involvement in DISH, as well as the need for refined diagnostic criteria.

Learning Objectives

By the end of this lecture, participants will be able to:

1. Identify the imaging features of DISH across X-ray, CT, and MRI, including spinal and extra-spinal manifestations.
2. Differentiate DISH from spondyloarthritis and degenerative spinal changes using key diagnostic clues.
3. Understand the clinical relevance of DISH, including its links to metabolic syndrome, risk of fractures, dysphagia, and pelvic enthesopathy.
4. Recognize the limitations of current classification criteria and appreciate ongoing research efforts toward improved diagnostic definitions.
5. Apply practical imaging strategies to evaluate DISH comprehensively, including whole-spine CT in trauma cases and sacroiliac joint assessment.