Diffuse idiopathic skeletal hyperostosis: Can we identify a peripheral pattern?

Diffuse idiopathic skeletal hyperostosis is a bone disease characterized by ossification of spinal ligaments and peripheral entheses. Currently, we still use the classic classification criteria that do not include extraspinal manifestations. A number of authors agree on the need to revise them. We present 3 patients in which a diagnosis of diffuse idiopathic skeletal hyperostosis could not be established if we apply those criteria, but they have fully compatible clinical and radiological manifestations of hyperostotic disease.