A probable case of diffuse idiopathic skeletal hyperostosis (DISH) from an early modern crypt in Eastern Germany

Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory joint disease mainly characterised by the ossification of the right anterior longitudinal ligament and the presence of enthesopathies. Studies have shown that the disease typically affects malesof advanced age. This is a case report of a female individual, aged between 40-60 years, dating to 1472-1635 AD and found in Eastern Germany. A differential diagnosis was completedfollowing macroscopic examination and radiographicimaging of the affected bones. The resultsshowseveral pathological features that resemble skeletal characteristicsof DISH, besides other diseases. Therefore, we discuss DISH and provide a differential diagnosis of additional pathologies. Our case is particularly important becauseancient female DISH cases are underrepresented and the burial location indicatesa possible noble or monastic context, both linkedwith a lifestyle knownto be related to DISH.