Diffuse idiopathic skeletal hyperostosis (DISH) is a skeletal disease characterized by ligamentous ossi® cation of the antero-lateral side of the spine. The prevalence of DISH was studied in a cross-sectional, population-based study of Hungarian men and women, 50 years and over. The study was based on an analysis of the lateral thoracic and lateral lumbar radiographs of 635 persons recruited from a population register in Budapest, Hungary. Radiographs were taken according to standardised protocol and DISH was classi® ed using the Resnick and modi® ed Resnick criteria. The prevalence of hyperostosis according to the modi® ed Resnick criteria was 27.3% in men and 12.8% in women. There was an increase in the prevalence of DISH with increasing age in men, from 10.0% in the 50 ± 54 year age group to 36.6% in those over 75 years, and in women from 1.9% to 25.9% in the same age groups. According to this radiology survey the disease is more frequent and more severe in men than in women throughout life.

In this study we examined 22 Hungarian male probands with gout and 105 of their first degree relatives. This was the first family study in Hungary in which the characteristics of distribution of gout and hyperuricaemia among patients with gout and their first degree relatives, as well as the possible correlation between the prevalence of the disease and MHC class I antigens was investigated. Our gout patients showed the following characteristics: (1) There was a typical onset after age 40, benign oligoarticular form of arthritis, underexcretion of uric acid, moderate hypertension without evidence of reduced renal function, and a relatively high frequency of hyperostosis. (2) The prevalence of hyperuricaemia and gout exceeded the general population level in the first degree relatives of our gout patients. (3) The distribution of MHC class I antigens among the first degree relatives of our patients with gout showed no characteristic patterns. (4) There was no correlation between HLA B27 antigens and prevalence of gout or hyperostosis in family sibling studies. (5) The high frequency of gout and hyperuricaemia, as well as the lack of characteristic HLA patterns among the first degree relatives of gout patients in our family studies, point to the possible cumulative effect of several genes and environmental factors in the etiopathogenesis of this disease.

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