MEDICAL CONDITIONS
Diffuse Idiopathic Skeletal Hyperostosis
("DISH" or Forestier Disease)
What is diffuse idiopathic skeletal hyperostosis?
Diffuse idiopathic skeletal hyperostosis (DISH) has also been called Forestier's disease. It is considered a form of degenerative arthritis. DISH is characterised by flowing calcification along the sides of the vertebrae of the spine. It is also commonly associated with inflammation (tendinitis) and calcification of tendons at their attachments points to bone. This can lead to the formation of bone spurs, such as heel spurs. In fact, heel spurs are common among individuals with DISH.
What are symptoms of diffuse idiopathic skeletal hyperostosis?
Symptoms of DISH include intermittent pains in the areas of the bony changes of the spine and inflamed tendons. Stiffness and dull pain, particularly in the upper and lower back, are common. Sometimes pains in these areas can be sharp with certain body movements, such as twisting or bending over.
DISH is only slowly progressive. Calcifications between the vertebrae occur over many years. This calcification can lead to limitation of motion of the involved areas of the spine.
Does diffuse idiopathic skeletal hyperostosis damage organs?
There is no associated threat to any internal organs with this disorder. Rarely, large bone spurs can form in front of the spinal vertebrae of the neck. These spurs occasionally interfere with the passage of food through the upper esophagus (swallowing tube).
How is diffuse idiopathic skeletal hyperostosis treated?
Because areas of the spine and tendons can become inflamed, anti-inflammatory medications (NSAIDs), such as ibuprofen and Naproxen , can be helpful in both relieving pain and inflammation of DISH. It is hoped that by minimizing inflammation in these areas, further calcification of tendons and ligaments of the spine leading to calcific bony outgrowths (osteophytes) will be prevented.
Medical Author: William C. Shiel Jr., MD, FACP, FACR
For further information, please read the Osteoarthritis article.
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