Diffuse Idiopathic Skeletal Hyperostosis and Its Relation to Back Pain Among Older Men: The MrOS Study

Kathleen F. Holton, Patrick J. Denard, Jung U. Yoo, Deborah M. Kado, Elizabeth Barrett-Connor, Lynn M. Marshall

Research output: Contribution to journalArticlepeer-review

88 Scopus citations


Objectives: To estimate the prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in a cross-sectional study of elderly men age 65 to 100 years and to examine back and neck pain as possible correlates of DISH. Methods: DISH was defined using Resnick's criteria and scored according to Mata on lateral spine radiographs of 298 randomly selected participants from the MrOS Study. Standardized self-reported questionnaires were used to assess the frequency and severity of back and neck pain, and the relation of these to DISH status was estimated with X 2 tests, as well as prevalence ratios and 95% confidence intervals using log-binomial regression models. Results: DISH was observed in 126 older men (42%), increased with age (30%, 39%, 48%, and 56% for ages 65-69, 70-74, 75-79, and ≥80 respectively), and was positively associated with body mass index (BMI) (P = 0.04) and blood pressure (P = 0.02). Significantly less back pain in the past 12 months was reported among men with DISH as compared to men without (59% vs 71%, P = 0.03), which remained after adjustment for age, BMI, and blood pressure (prevalence ratios = 0.73, 95% confidence interval = 0.57-0.95). Back pain severity (P = 0.07) and frequency (P = 0.06) were also less frequent among men with DISH compared to men without, whereas reported neck pain was similar between groups (P = 0.39). Conclusions: Among community-dwelling elderly men, DISH prevalence is high, increases with age, and is positively associated with BMI and blood pressure. Frequency of self-reported back pain over the past 12 months was lower in older men with DISH as compared to those without DISH.

Original languageEnglish (US)
Pages (from-to)131-138
Number of pages8
JournalSeminars in Arthritis and Rheumatism
Issue number2
StatePublished - Oct 2011


  • Back pain
  • Diffuse idiopathic skeletal hyperostosis
  • Male
  • Neck pain

ASJC Scopus subject areas

  • Rheumatology
  • Anesthesiology and Pain Medicine


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