The 82nd Annual Meeting of the American Association of Physical Anthropologists (2013)

The interaction of DISH and Obesity on a pathological anterior pubis


1Department of Anthropology, University of Tennessee, Knoxville, 2Department of Anatomy, University of Pretoria, 3Department of Anthropology, Texas State University-San Marcos

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Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic disorder of unknown etiology affecting the axial and appendicular skeleton. The most recognizable feature of DISH is fusion of the anterolateral vertebral bodies with preservation of the intervertebral disc space. While the clinical and paleopathological literature infrequently discusses attendant fusion of other bony sites or skeletal areas, literature has posited that obesity may play a role in the formation of DISH.

The skeleton of an obese white female (+400lbs) at Texas State University-San Marcos presented with fusion of the vertebral column and multiple costovertebral joints typical of DISH, along with unusual skeletal outgrowths affecting the left and right pubic symphyseal faces. In order to document the prevalence of this pubic bone defect, 84 individuals from the William M. Bass Donated Skeletal Collection were examined. Inclusion criteria comprised of differential diagnosis of DISH or ankylosing spondylitis and/or obesity (>250lbs). One white male (+400lbs) had similar skeletal manifestations on the pubic symphysis with associated vertebral and unilateral sacroiliac fusion indicative of DISH. These two individuals demonstrate the potential interaction of DISH with obesity and the various skeletal outgrowths that may result.

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