HEADER Patient: Male, 61 years Study dates: Composite radiographic axial/sacropelvic set obtained in 3 clinically related sessions within less than 4 weeks; exact individual dates not provided Regions: Cervical spine, thoracic spine, lumbar spine, sacroiliac joints, pelvis, bilateral hips Projection set provided:
Cervical spine: AP, lateral, right oblique, left oblique, open-mouth odontoid
Thoracic spine: AP, lateral projections
Lumbar spine: AP, lateral, focused lumbosacral lateral, right oblique, left oblique
Sacroiliac joints: AP plus right and left oblique views
Pelvis/hips: AP pelvis plus right and left frog-leg lateral hips Modality: XR Adequacy: Submitted projection set is adequate for integrated structural axial and sacropelvic assessment.
FINDINGS
Cervical spine Mild straightening of the normal cervical lordosis. No acute cervical malalignment. Vertebral body heights are preserved. Odontoid is intact. Atlantodental alignment is maintained. No erosive atlantoaxial change identified. Mild degenerative disc-space loss at C3-C4. Advanced disc-space loss at C4-C5 and C5-C6. Moderate to advanced disc-space loss at C6-C7. Associated endplate sclerosis and anterior/posterior osteophytes are present at C4-C7, greatest at C4-C5 through C6-C7. Multilevel uncovertebral hypertrophy and facet arthropathy are present, with bilateral osseous foraminal narrowing, greatest from C4-C5 through C6-C7 and overall moderate, focally moderate-severe. Lower cervical anterior non-marginal ossific spurring/bridging tendency is present, but the most developed flowing ossification phenotype is thoracic rather than cervical. No cervical marginal syndesmophyte pattern. No cervical ankylosis.
Thoracic spine Mildly increased thoracic kyphotic curvature. Thoracic vertebral body heights are preserved without focal compression deformity. Multilevel mild to moderate thoracic disc degeneration and endplate sclerosis are present, greatest in the upper/mid thoracic region. Along the anterior and right anterolateral thoracic spine there is bulky flowing ossification with bridging and near-bridging continuity across multiple contiguous levels, most conspicuous in the mid thoracic spine and extending across at least 4 contiguous vertebral levels, overall greater than would be expected for ordinary isolated degenerative endplate osteophytes. Right-sided thoracic predominance is present. This “flowing wax-like” ossification pattern is the dominant thoracic finding. No destructive endplate erosion. No ankylosing-spondylitis-type thin marginal syndesmophytes identified.
Lumbar spine Mild levoconvex lumbar curvature. No acute lumbar malalignment. Vertebral body heights are preserved. Degenerative disc disease is present at multiple levels. Mild to moderate thoracolumbar disc degeneration is present at T12-L1/L1-L2, including vacuum phenomenon at the thoracolumbar junction. Mild disc degeneration at L2-L3 and L3-L4. Advanced disc-space loss at L4-L5 with vacuum phenomenon, endplate sclerosis, and osteophytes. Moderate to advanced disc-space loss at L5-S1 with endplate sclerosis and osteophytes. Lower lumbar facet arthropathy is present, greatest at L4-L5 and L5-S1, overall moderate to severe. Anterior non-marginal ossific spurring/bridging tendency continues into the thoracolumbar/lumbar region, but the lumbar spine remains dominated by superimposed degenerative disc and facet disease. No lumbar marginal syndesmophytes. No lumbar ankylosis. No vertebral compression fracture identified.
Sacroiliac joints Sacroiliac joints are preserved bilaterally. Mild degenerative marginal spurring only. No convincing erosions. No subchondral ankylosis. No radiographic sacroiliitis pattern.
Pelvis and hips No acute pelvic osseous abnormality identified on submitted views. Mild degenerative change at the pubic symphysis. Right hip shows mild to moderate osteoarthrosis with superior-predominant joint-space narrowing, mild subchondral sclerosis, and small marginal osteophytes. Left hip shows moderate-severe to severe osteoarthrosis with marked superior joint-space narrowing, subchondral sclerosis, subchondral cystic change/geodes at the acetabular side, and femoral head-neck/acetabular osteophytes with remodeling. Multiple bilateral calcified nodules in the gluteal soft tissues.
COMPARISON No prior matched axial or sacropelvic radiographs were provided for interval comparison. This report integrates only the submitted short-interval composite set.
IMPRESSION
Radiographic appearance is DISH-dominant, with classic bulky flowing anterolateral ossification along the thoracic spine, most pronounced on the right, bridging/near-bridging across multiple contiguous thoracic levels.
The ossification phenotype continues into the lower cervical/cervicothoracic and thoracolumbar/lumbar spine, although the most fully developed and diagnostically dominant manifestation is thoracic.
Superimposed multilevel degenerative spondylosis/degenerative disc disease is present in the cervical, thoracic, and lumbar spine, greatest at C4-C7 and L4-L5/L5-S1, with lower lumbar facet arthropathy.
No radiographic sacroiliitis and no ankylosing-spondylitis-type thin marginal syndesmophyte pattern identified on the submitted set.
Asymmetric bilateral hip osteoarthritis, markedly greater on the left, where changes are moderate-severe to severe; right hip osteoarthritis is mild to moderate.
No acute vertebral compression fracture identified on the submitted views.
Multiple bilateral calcified nodules in the gluteal soft tissues.
EMR SUMMARY Composite short-interval axial/sacropelvic radiographs demonstrate a DISH-dominant mixed axial structural pattern. The dominant abnormality is classic flowing anterolateral thoracic ossification with right-sided predominance and multilevel bridging/near-bridging continuity, extending in lesser degree into adjacent cervical and lumbar regions. Superimposed multilevel degenerative cervical and lumbar spondylosis/disc disease is present, greatest at C4-C7 and L4-S1, with lower lumbar facet arthropathy. Sacroiliac joints are non-erosive and non-ankylosed, without radiographic sacroiliitis or ankylosing-spondylitis-type marginal syndesmophytes. Hips show asymmetric osteoarthritis, severe on the left and mild-moderate on the right. DISH tag: positive. Degenerative tag: positive. Inflammatory axial SpA radiographic pattern: not demonstrated. Fracture tag: negative.
FOOTER RheumaView™ is a physician-curated reporting assistant and not an FDA-approved diagnostic device. Outputs support clinical decision-making; the treating physician retains full responsibility.
Research / Analytics Addendum
HEADER Patient: Male, 61 years Study structure: Self-contained research addendum linked to a 3-session short-interval composite axial/sacropelvic radiographic set Regions analyzed: Cervical spine, thoracic spine, lumbar spine, sacroiliac joints, pelvis, bilateral hips Source constraints: Plain-film XR only; no DICOM calibration values, no prior matched radiographs, no MRI/CT, no DEXA provided Quantitation note: Numeric values below are XR-derived semi-quantitative research estimates and ordinal burden measures based on submitted views; fields requiring unavailable cross-modal or longitudinal inputs are rendered as N/A rather than inferred.
A. Quantitative Radiologic Measures
A1. Region-Level Structural Burden Summary
Region
Dominant pattern
Total structural burden (0–4)
Inflammatory-pattern burden (0–4)
Degenerative burden (0–4)
DISH-pattern burden (0–4)
Confidence
Cervical spine
mixed, degeneration-predominant with anterior ossification phenotype continuation
3
0
3
1
High
Thoracic spine
DISH-dominant mixed axial pattern
4
0
2
4
High
Lumbar spine
mixed, degeneration-predominant with anterior ossification phenotype continuation
classic flowing morphology, not thin marginal syndesmophyte pattern
Thoracic right-lateralization score
0.78
marked right-sided dominance
Axial mixed-pattern integration score
0.81
coherent coexistence of DISH + degeneration
Structural inflammatory mimic penalty
0.07
low
B. Extended Bone-Health Models
Field
Value
Extended bone-quality vector
N/A
Investigational bone-response signature
N/A
Density-linked structural lag model
N/A
C. Infection / Oncologic Advanced Operators
Field
Result
Imaging infection concern level
low / not supported on current radiographs
Oncologic concern vector
low / not supported on current radiographs
Therapy-related structural change signature
not identified
D. Advanced Symmetry Maps
Field
Value
Comment
Higher-order thoracic asymmetry score
0.80
right-dominant flowing ossification
Higher-order hip asymmetry score
0.55
left-dominant OA burden
SI symmetry preservation score
0.95
preserved
Composite asymmetry phenotype
focal-right thoracic / focal-left hip
mixed non-random asymmetry
E. Genetic / Developmental Modulation
Field
Value
Developmental modulation layer
not applicable
Genetic modulation field
not computable from current data
Pediatric/developmental normalization
not applicable
F. External Integration / Provenance Signals
Field
Value
External model source
none supplied
External provenance weight
N/A
Additional external scoring hook
not used
Manual provenance note
DISH-dominant phenotype weighting retained after mixed-pattern reconciliation
G. QA & Data Integrity Extensions
Field
Value
Dataset type
short-interval composite axial/sacropelvic set
Experimental layer status
active
Quantitative missingness items
no priors; no DEXA; no paired blinded human scoring matrix; no external AI source
Table completeness
complete for all declared regions
Visible-text sanitization status
clean
Final research surface status
complete within available XR-only inputs
FOOTER RheumaView™ is a physician-curated reporting assistant and not an FDA-approved diagnostic device. Outputs support clinical decision-making; the treating physician retains full responsibility. Research-tier analytics are additive and do not modify the validated clinical core.
