Diffuse idiopathic skeletal hyperostosis
Other Names for this Disease
- Ankylosing vertebral hyperostosis with tylosis
- DISH Forestier's disease
- Forestier disease
- Forestier-Rotes disease
What are the signs and symptoms of diffuse idiopathic skeletal hyperostosis (DISH)?
What causes diffuse idiopathic skeletal hyperostosis (DISH)?
How might diffuse idiopathic skeletal hyperostosis (DISH) be treated?
What is the prognosis for individuals with diffuse idiopathic skeletal hyperostosis (DISH)?
- Stiffness which is most noticeable in the morning.
- Pain when pressure is applied to the affected area.
- Loss of lateral range of motion.
- Difficulty swallowing or a hoarse voice, particularly if the cervical spine is affected.
Treatment for pain caused by diffuse idiopathic skeletal hyperostosis is similar to that of other joint ailments. Pain relievers, such as acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others) may be of some benefit. More severe pain can be treated with corticosteroid injections.
Staying active and getting regular exercise may help to reduce the symptoms of diffuse idiopathic skeletal hyperostosis. Walking, swimming, stretching and yoga are good exercises for managing the symptoms of diffuse idiopathic skeletal hyperostosis.
Surgery may be required in rare cases when diffuse idiopathic skeletal hyperostosis causes severe complications. People who experience difficulty swallowing due to large bone spurs in the neck may need surgery to remove the bone spurs. Surgery may also relieve pressure on the spinal cord caused by diffuse idiopathic skeletal hyperostosis.
- Disability. Loss of range of motion in the affected joint can make it difficult to use that joint. For instance, diffuse idiopathic skeletal hyperostosis in the shoulder can make it difficult and painful to use the arm.
- Difficulty swallowing. Bone spurs associated with diffuse idiopathic skeletal hyperostosis in the neck (cervical spine) can put pressure on the esophagus, making it difficult to swallow. The pressure from bone spurs can also cause a hoarse voice or difficulty breathing during sleep (sleep apnea). In rare circumstances this can become serious and may require surgery to remove the bone spurs.
- Paralysis. Diffuse idiopathic skeletal hyperostosis that affects the ligament running up the outside of the spine (posterior longitudinal ligament) can put pressure on the spinal cord. Spinal cord compression may result in a loss of feeling and paralysis.
- Diffuse Idiopathic Skeletal Hyperostosis (DISH). The Arthritis Society. 2013; http://www.arthritis.ca/page.aspx?pid=919. Accessed 11/14/2013.
- Diffuse idiopathic skeletal hyperostosis (DISH). Mayo Foundation for Medical Education and Research. November 2, 2012; http://www.mayoclinic.com/print/diffuse-idiopathic-skeletal-hyperostosis/DS00740/DSECTION=all&METHOD=print. Accessed 11/17/2013.