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Diseases

Genetic and Rare Diseases Information Center (GARD)

Diffuse idiopathic skeletal hyperostosis

*

* Not a rare disease

Other Names for this Disease
  • DISH Forestier's disease
  • Forestier disease
  • DISH
  • Forestier-Rotes disease
  • Ankylosing vertebral hyperostosis with tylosis
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Treatment

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How might diffuse idiopathic skeletal hyperostosis be treated?

Treatment of diffuse idiopathic skeletal hyperostosis (DISH) is focused on the signs and symptoms present in each person. For example, pain caused by DISH is often treated with pain relievers, such as acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others). Affected people with severe pain may be treated with corticosteroid injections.[1][2]

Physical therapy and/or exercise may reduce the stiffness associated with DISH and can help increase range of motion in the joints.[1][2]

In rare cases, surgery may be necessary if severe complications develop. For example, people who experience difficulty swallowing may need surgery to remove the bone spurs in the neck.[1][2]
Last updated: 5/11/2015

How might severe diffuse idiopathic skeletal hyperostosis (DISH) be treated?

Although diffuse idiopathic skeletal hyperostosis (DISH) affects 25% of men and 15% of women over the age of 50 years old, many affected people do not have symptoms. However some people with DISH have stiffness and pain, most commonly in the spinal region or back.  In rare cases the joint stiffness and pain is severe and the areas of the spine affected by DISH may have very limited movement. Knees, hips, hands and other joints may also be affected, more commonly in the more severe cases.[3][4]

Therapy for DISH is based on symptoms. In general, physical therapy, analgesics, sedation, anti-inflammatory drugs, and muscle relaxants have all been successful in managing the majority of patients with DISH.[4]

Even though few studies have focused on indications for surgery, it is generally accepted that surgery is indicated for patients with severe symptoms (such as airway obstruction and/or dysphagia) in whom conservative approach has failed.[4]
Last updated: 12/31/2015

References
  1. 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.
  2. Simon M Helfgott, MD. Diffuse idiopathic skeletal hyperostosis (DISH). UpToDate. December 2013; Accessed 5/11/2015.
  3. Mader R, Verlaan JJ, & Buskila D. Diffuse idiopathic skeletal hyperostosis: clinical features and pathogenic mechanisms. Nat Rev Rheumatol. December 2013; 9(12):741-50. http://www.ncbi.nlm.nih.gov/pubmed/24189840. Accessed 12/31/2015.
  4. Nascimento FA, Gatto LAM, Lages RO, Neto HM, Demartini Z, & Koppe GL. Diffuse idiopathic skeletal hyperostosis: A review. Surgical Neurology International. 2014; 5(Suppl 3):S122-S125. http://www.ncbi.nlm.nih.gov/pubmed/24843807. Accessed 12/31/2015.


Other Names for this Disease
  • DISH Forestier's disease
  • Forestier disease
  • DISH
  • Forestier-Rotes disease
  • Ankylosing vertebral hyperostosis with tylosis
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.