• DISH;
  • HFI;
  • hyperostosis


Diffuse idiopathic skeletal hyperostosis (DISH) and hyperostosis frontalis internus (HFI) are both characterised by abnormal bone growth, a late age of onset, and an association with obesity, acromegaly and various metabolic disorders. In this study we examined the co-occurrence of DISH and HFI in a sample of 406 black and whites aged 40–102 years old from the Terry Collection, National Museum of Natural History, Smithsonian Institution. Fisher's exact tests showed the co-occurrence was significant for females. DISH was present in 19.6% of black and 29.6% of white females with HFI versus 4.76% and 2.38% of control females without HFI. A similar frequency of DISH was seen in males with HFI (20% black and 27.3% white), but this was not significantly different from the male controls without HFI (16.8% and 18.9%). The risk of developing DISH for females with HFI was nearly 8.78 times greater (CI = 2.56–30.1) than for females without HFI. Logistic regression of the female data showed HFI was a significant determinant (p = 0.001) of the presence of DISH but age was not (p = 0.744). We suggest that similar metabolic, genetic and environmental risk factors in the pathogenesis of the two conditions explain the observed comorbitity. Copyright © 2010 John Wiley & Sons, Ltd.