What is Diffuse Idiopathic Skeletal Hyperostosis?

Category: Spine | Author: Stefano Sinicropi

 

Diffuse Idiopathic Skeletal Hyperostosis

Diffuse idiopathic skeletal hyperostosis, oftentimes referred to as DISH or Forestier’s disease, is categorized by the calcification of ligaments in areas where they attach to a person’s spine. DISH is sometimes asymptomatic and doesn’t need treatment, but other cases are categorized by mild to moderate back pain and stiffness. Below, we explain why the condition sets in, and how it is treated.

DISH Causes and Symptoms

While there aren’t any direct causes that lead to diffuse idiopathic skeletal hyperostosis, medical experts have identified a few risk factors that heighten a person’s chance of developing the condition. They are:

  • Being a male
  • Being over the age of 50
  • Having other health conditions like diabetes, insulin deficiency or being obese
  • Taking certain medications called retinoids or high levels of Vitamin A supplements

As we mentioned above, some people can develop DISH and experience no symptoms, but others will experience a range of symptoms including pain, stiffness in the back, neck, shoulders or knees, loss of range of motion and difficulty swallowing. Left untreated, the condition can also increase a person’s risk of suffering a spinal fracture.

DISH Diagnosis and Treatment

If you are experiencing any of the above symptoms, set up a consultation with a spine specialist. The assessment will begin by asking you about your symptoms and will likely involve a physical exam. If you experience pain during certain pressure tests on your spine, it could be an indication of DISH. A doctor can also confirm the diagnosis with the assistance of an x-ray, CT scan or MRI.

There is no known cure for diffuse idiopathic skeletal hyperostosis, but there are steps you can take to lessen the damage and reduce symptom prevalence. Conservative treatment involves maintaining a healthy weight, getting regular moderate-intensity exercise, regular use of therapeutic heat pads, pain relievers/anti-inflammatory medications, physical therapy and corticosteroid injections.

In rare cases, surgery may be necessary. This is generally only for people who are having difficulty swallowing due to the condition, as this can be life threatening. Your surgeon can walk you through the specifics of the operation should surgery be needed.

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