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Case report
Diffuse idiopathic skeletal hyperostosis in a 33-year-old woman with PCOS and metabolic syndrome: a rare scenario
  1. Jojin Jose Chitten and
  2. Boblee James
  1. Orthopaedics, Sree Lakshmi Narayana Institute of Medical Sciences and Hospital, Puducherry, India
  1. Correspondence to Dr Jojin Jose Chitten; jojinjosec{at}


Diffuse idiopathic skeletal hyperostosis (DISH) is a common degenerative enthesopathy seen in the elderly with male preponderance. It is uncommon in patients before 50 years of age and is extremely rare in patients younger than 40 years. We report a case of 33-year-old unmarried woman who presented with inflammatory spinal pain and stiffness, limited chest expansion, decreased range of spinal motion and postural abnormalities, all of which suggested the diagnosis of ankylosing spondylitis, considering the patient’s age. But, further evaluation led us to the final diagnosis of DISH with associated metabolic syndrome and polycystic ovarian syndrome (PCOS). To the best of our knowledge, our patient is the first reported case of DISH in a woman less than 40 years of age, and also the first case of DISH associated with PCOS and metabolic syndrome.

  • diffuse idiopathic skeletal hyperostosis
  • DISH
  • ankylosing spondylitis
  • metabolic syndrome
  • polycystic ovarian syndrome
  • PCOS

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  • Contributors JJC and BJ have contributed to the planning, conduct, acquisition of data and interpretation of dataand reporting of the work described in this article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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