The role of antemortem images of diffuse idiopathic skeletal hyperostosis (DISH) in positive identification

Abstract

The present study aimed to test the accuracy of using diffuse idiopathic skeletal hyperostosis (DISH) to make positive identifications using the method of antemortem and postmortem radiographic comparison. An online survey was developed to evaluate whether DISH is a feature of the skeleton that can be used in radiographic image comparison. Three digital radiographic images from 51 individuals were gathered for use in this study: one image taken at a baseline date (Group A), one image taken within 2 years from baseline (Group B), and one image taken greater than 4.5 years from baseline (Group C). A total of 40 survey participants were tasked with comparing between a simulated “antemortem” image and a “postmortem” image from living patients and identifying which image pair represented the same individual at different time intervals. Information about survey participants’ field, degree, experience working with radiographs, and familiarity with DISH were also recorded. Accuracy, sensitivity, and specificity were measured. Series 1 compared Group A images to Group B images and resulted in an accuracy of 87.3%, sensitivity of 46.9%, and specificity of 94.3%. Series 2 compared Group A images to Group C images and resulted in an accuracy of 83.4%, sensitivity of 34.3%, and specificity of 95.8%. The study concluded that the characteristics of DISH did not prove reliable for making positive identifications but established that DISH could be used to narrow down potential matches.