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But, further evaluation led us to the final diagnosis of DISH with associated metabolic syndrome and polycystic ovarian syndrome (PCOS). To the best of our knowledge, our patient is the first reported case of DISH in a woman less than 40 years of age, and also the first case of DISH associated with PCOS and metabolic syndrome.<\/jats:p>","DOI":"10.1136\/bcr-2017-223740","type":"journal-article","created":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T06:37:59Z","timestamp":1572590279000},"page":"e223740","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Diffuse idiopathic skeletal hyperostosis in a 33-year-old woman with PCOS and metabolic syndrome: a rare scenario"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5478-7580","authenticated-orcid":false,"given":"Jojin Jose","family":"Chitten","sequence":"first","affiliation":[{"name":"Orthopaedics, Sree Lakshmi Narayana Institute of Medical Sciences and Hospital, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boblee","family":"James","sequence":"additional","affiliation":[{"name":"Orthopaedics, Sree Lakshmi Narayana Institute of Medical Sciences and Hospital, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,10,31]]},"reference":[{"key":"2025082706595159000_12.10.e223740.1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.9.4.321"},{"key":"2025082706595159000_12.10.e223740.2","unstructured":"Resnick D , Niwayama G . 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