Case Report: Identifying Andersson-Like Lesions in Diffuse Idiopathic Skeletal Hyperostosis

Andersson lesions (ALs) in ankylosing spondylitis (AS) pose a severe risk to the stability of ankylosed spine, which might result in significant deterioration of spinal cord function after traumatic or inflammatory causes. Herein, erosive discovertebral lesions in diffuse idiopathic skeletal hyperos...

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Autores principales:	Xiaojiang Sun, Han Qiao, Xiaofei Cheng, Haijun Tian, Kangping Shen, Wenjie Jin, Xingzhen Liu, Qiang Wang, Yiming Miao, Yue Xu, Changqing Zhao, Jie Zhao
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	Andersson-like lesion (ALL) diffuse idiopathic skeletal hyperostosis (DISH) spinal stability ossification focal stress concentration Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/91feb54df44a47f9a687cd105d3639f9
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spelling	oai:doaj.org-article:91feb54df44a47f9a687cd105d3639f92021-12-01T18:10:16ZCase Report: Identifying Andersson-Like Lesions in Diffuse Idiopathic Skeletal Hyperostosis1664-239210.3389/fendo.2021.766209https://doaj.org/article/91feb54df44a47f9a687cd105d3639f92021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.766209/fullhttps://doaj.org/toc/1664-2392Andersson lesions (ALs) in ankylosing spondylitis (AS) pose a severe risk to the stability of ankylosed spine, which might result in significant deterioration of spinal cord function after traumatic or inflammatory causes. Herein, erosive discovertebral lesions in diffuse idiopathic skeletal hyperostosis (DISH) presented important clinical similarities to AL in AS, but failed to completely recognize unstable spinal lesions. Therefore, we pioneered to identify spinal discovertebral lesions similar to Andersson-like lesions (ALLs) in DISH, followed by the characterization and summarization of the etiology, radiology, laboratory results, clinical symptoms, and treatment strategies for AL in AS with ALL in DISH. By characterizing the ALL in DISH cases, we showed that the ALL was mainly traumatic and established at the junction of focal stress between two adjacent ossified level arms. Erosive discovertebral ALLs were formed after trivial stress of direct impact and could be subdivided into transdiscal, transvertebral, and discovertebral types radiologically. Patients who presented with ALL frequently suffered from consistent back pain clinically and experienced a decrease in motion ability that could reflect skeletal stability, which received treatment effectiveness after conservative external spinal immobilization or further surgical internal fixation, indicating the significance of recognizing ALL in the ankylosed DISH spine to further maintain spinal stability in order to prevent catastrophic neurologic sequelae. Our work highlighted the clinical relevance of ALL in DISH in comparison with AL in AS, which provided broader insight to identify ALL in DISH, thus facilitating early intervention against DISH deterioration.Xiaojiang SunXiaojiang SunHan QiaoHan QiaoXiaofei ChengXiaofei ChengHaijun TianHaijun TianKangping ShenKangping ShenWenjie JinWenjie JinXingzhen LiuXingzhen LiuQiang WangYiming MiaoYue XuChangqing ZhaoChangqing ZhaoJie ZhaoJie ZhaoFrontiers Media S.A.articleAndersson-like lesion (ALL)diffuse idiopathic skeletal hyperostosis (DISH)spinal stabilityossificationfocal stress concentrationDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Andersson-like lesion (ALL) diffuse idiopathic skeletal hyperostosis (DISH) spinal stability ossification focal stress concentration Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	Andersson-like lesion (ALL) diffuse idiopathic skeletal hyperostosis (DISH) spinal stability ossification focal stress concentration Diseases of the endocrine glands. Clinical endocrinology RC648-665 Xiaojiang Sun Xiaojiang Sun Han Qiao Han Qiao Xiaofei Cheng Xiaofei Cheng Haijun Tian Haijun Tian Kangping Shen Kangping Shen Wenjie Jin Wenjie Jin Xingzhen Liu Xingzhen Liu Qiang Wang Yiming Miao Yue Xu Changqing Zhao Changqing Zhao Jie Zhao Jie Zhao Case Report: Identifying Andersson-Like Lesions in Diffuse Idiopathic Skeletal Hyperostosis
description	Andersson lesions (ALs) in ankylosing spondylitis (AS) pose a severe risk to the stability of ankylosed spine, which might result in significant deterioration of spinal cord function after traumatic or inflammatory causes. Herein, erosive discovertebral lesions in diffuse idiopathic skeletal hyperostosis (DISH) presented important clinical similarities to AL in AS, but failed to completely recognize unstable spinal lesions. Therefore, we pioneered to identify spinal discovertebral lesions similar to Andersson-like lesions (ALLs) in DISH, followed by the characterization and summarization of the etiology, radiology, laboratory results, clinical symptoms, and treatment strategies for AL in AS with ALL in DISH. By characterizing the ALL in DISH cases, we showed that the ALL was mainly traumatic and established at the junction of focal stress between two adjacent ossified level arms. Erosive discovertebral ALLs were formed after trivial stress of direct impact and could be subdivided into transdiscal, transvertebral, and discovertebral types radiologically. Patients who presented with ALL frequently suffered from consistent back pain clinically and experienced a decrease in motion ability that could reflect skeletal stability, which received treatment effectiveness after conservative external spinal immobilization or further surgical internal fixation, indicating the significance of recognizing ALL in the ankylosed DISH spine to further maintain spinal stability in order to prevent catastrophic neurologic sequelae. Our work highlighted the clinical relevance of ALL in DISH in comparison with AL in AS, which provided broader insight to identify ALL in DISH, thus facilitating early intervention against DISH deterioration.
format	article
author	Xiaojiang Sun Xiaojiang Sun Han Qiao Han Qiao Xiaofei Cheng Xiaofei Cheng Haijun Tian Haijun Tian Kangping Shen Kangping Shen Wenjie Jin Wenjie Jin Xingzhen Liu Xingzhen Liu Qiang Wang Yiming Miao Yue Xu Changqing Zhao Changqing Zhao Jie Zhao Jie Zhao
author_facet	Xiaojiang Sun Xiaojiang Sun Han Qiao Han Qiao Xiaofei Cheng Xiaofei Cheng Haijun Tian Haijun Tian Kangping Shen Kangping Shen Wenjie Jin Wenjie Jin Xingzhen Liu Xingzhen Liu Qiang Wang Yiming Miao Yue Xu Changqing Zhao Changqing Zhao Jie Zhao Jie Zhao
author_sort	Xiaojiang Sun
title	Case Report: Identifying Andersson-Like Lesions in Diffuse Idiopathic Skeletal Hyperostosis
title_short	Case Report: Identifying Andersson-Like Lesions in Diffuse Idiopathic Skeletal Hyperostosis
title_full	Case Report: Identifying Andersson-Like Lesions in Diffuse Idiopathic Skeletal Hyperostosis
title_fullStr	Case Report: Identifying Andersson-Like Lesions in Diffuse Idiopathic Skeletal Hyperostosis
title_full_unstemmed	Case Report: Identifying Andersson-Like Lesions in Diffuse Idiopathic Skeletal Hyperostosis
title_sort	case report: identifying andersson-like lesions in diffuse idiopathic skeletal hyperostosis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/91feb54df44a47f9a687cd105d3639f9
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Case Report: Identifying Andersson-Like Lesions in Diffuse Idiopathic Skeletal Hyperostosis

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