I'm looking for a system to score the severity and extension of DISH radiologically.
I only found Mata's et al. score, which I find is confusing.
Does anyone have experience with Mata's scoring system for DISH or use another scoring system to radiologically compare the severity of patients diagnosed with DISH?
Mata S and her colleagues (1998) developed a scoring system for DISH. They described the morphology of the ossified mass and obtained measurements. The Morphological description includes: Ossified anterior longitudinal ligament without osteophytes or with non-bridging / bridging osteophytes with scores of: 1, 2 and 3 points respectively. Score 4 was described for bridging osteophytes larger than 10 mm?!
The article describes that the measurements are taken twice at the superior and inferior end plates of opposing vertebrae at each disc level.
I have these queries:
1. It is not clear if one score will be given for each disc level (averaging the measurements at the opposing upper and lower vertebral end plates), or if each vertebra is given a score by adding the measurements of its upper and lower end-plates.
2. The grading of Mata's scoring of DISH is not clear. what are the scores of mild or severe DISH?
3. Is Mata's system used also for diagnosis?
4. I found very few studies in the literature that used Mata's score. However, the impact of using the scoring system was not clear.
5. Is there another scoring system or method to describe and compare severity of DISH using mainly radiographic criteria not clinical?
(Mata S, Chhem RK, Fortin PR, Joseph L, Esdaile JM. Comprehensive radiographic evaluation of diffuse idiopathic skeletal hyperostosis: development and interrater reliability of a scoring system. Semin Arthritis Rheum 1998:28:88-96)
Diffuse idiopathic skeletal hyperostosis (DISH) which is a skeletal disease characterized by ligamentous ossification of the anterolateral side of the spine. And as regards to scoring system , for my knowledge there is no recent scoring system known to assesses the disease severity or correlate between the radiological and the clinical manifestation of the disease.
Thank you Dr Medhat for your reply.
I believe that a scoring system is needed for radiologically comparing the severity and extension of DISH in several patients and to follow up the condition in the same patient.
I have designed a scoring system based on modification of MATA's; it will need further refinement and to be tested.
Comprehensive radiographic evaluation of diffuse idiopathic skeletal hyperostosis: development and interrater reliability of a scoring system.
You may find this article of some value (PubMed)
Thank you Jan for your reply. The paper you suggested is the paper by Sonia Mata that I am discussing its score in this question.
Did you use this scoring system before?
Maybe this is helpful:
Diffuse idiopathic skeletal hyperostosis (DISH): Forestier's disease with extraspinal manifestations.
Resnick D, Shaul SR, Robins JM
Radiology. 1975 Jun; 115(3):513-24.
Yaniv G at al. proposed new scoring system for DISH in
The natural course of bridging osteophyte formation in diffuse idiopathic skeletal hyperostosis: retrospective analysis of consecutive CT examinations over 10 years
Rheumatology (Oxford). 2014 Nov;53(11):1951-7.