Diffuse idiopathic skeletal hyperostosis is a common condition characterized by bone proliferation at sites of tendinous and ligamentous insertion. The cervical and thoracic spine in particular are affected. There is an association with hyperglycemia and approximately one-third of patients test positive for human leukocyte antigen–B27.

The imaging findings are

• Florid, flowing ossification is noted along the anterior or right anterolateral aspects of at least four contiguous vertebrae.
• Disk spaces are usually well preserved.
• Enthesopathy of the iliac crest, ischial tuberosities, and greater trochanters and spur formation in the appendicular skeleton (olecranon, calcaneum) are frequently present.