In DISH with lumbar involvement, disc height on radiographs is typically what?

In DISH with lumbar involvement, disc height on radiographs is typically what?

• A. Normal (preserved)
• B. Decreased
• C. Increased
• D. Variable

Answer: (A)

In DISH, the problem is ossification of ligaments, especially the anterior longitudinal ligament, leading to flowing anterior osteophytes along the spine. This process tends to spare the intervertebral discs, so the disc spaces stay normal. Therefore, even with lumbar involvement and extensive ligamentous ossification, radiographs typically show preserved disc height rather than narrowing. This contrast with degenerative changes, where disc height often decreases due to disc degeneration.

In DISH, the problem is ossification of ligaments, especially the anterior longitudinal ligament, leading to flowing anterior osteophytes along the spine. This process tends to spare the intervertebral discs, so the disc spaces stay normal. Therefore, even with lumbar involvement and extensive ligamentous ossification, radiographs typically show preserved disc height rather than narrowing. This contrast with degenerative changes, where disc height often decreases due to disc degeneration.