Overview

Diffuse idiopathic skeletal hyperostosis (DISH) is a bony hardening (calcification) of ligaments in areas where they attach to your spine.

Also known as Forestier's disease, diffuse idiopathic skeletal hyperostosis may cause no symptoms and require no treatment. The most common symptoms are mild to moderate pain and stiffness in your upper back. DISH can also affect your neck and lower back. Some people have DISH in other areas, such as shoulders, elbows, knees and heels.

A non-inflammatory condition, DISH can be progressive. As it worsens, it can cause serious complications.

Source: http://www.mayoclinic.com

Symptoms

You might have no signs or symptoms with DISH. For those who have signs and symptoms, the upper portion of the back (thoracic spine) is most commonly affected. Signs and symptoms might include:

• Stiffness. Stiffness may be most noticeable in the morning.
• Pain. You may feel pain in your back or in other affected areas, such as your shoulder, elbow, knee or heel.
• Loss of range of motion. You may notice this most when stretching side to side.
• Difficulty swallowing or a hoarse voice. You may experience these if you have DISH in your neck.

When to see a doctor

Make an appointment with your doctor if you have persistent pain or stiffness in any joint or in your back.

Source: http://www.mayoclinic.com

Diagnosis

To determine whether you have DISH, your doctor may begin with a physical examination of your spine and joints. He or she will press lightly on your spine and joints to feel for abnormalities. Pain from the pressure on your spine may be a clue to the diagnosis. DISH may cause pain at the point where the affected tendon or ligament attaches to a bone.

Your doctor also will order imaging tests to help with the diagnosis. Tests that may be used include X-rays, CT scans or MRIs.

Source: http://www.mayoclinic.com

Complications

People with DISH are at risk of certain complications, such as:

• Disability. Loss of range of motion in the affected joint can make it difficult to use that joint. For instance, DISH in your shoulder can make it difficult to use your arm.
• Difficulty swallowing. Bone spurs in the neck can put pressure on your esophagus. The pressure from bone spurs can also cause a hoarse voice or sleep apnea, a sleep disorder in which you stop breathing repeatedly. Rarely, this can become serious and might require surgery to remove the bone spurs.
• Spinal fracture. DISH can increase your risk of breaking bones in your spine, especially if you have moderate to severe disease. Even minor injuries can cause fractures. Breaks may require surgery to repair.

Lifestyle and home remedies

To help you manage pain and stiffness and to halt progression of the disease, try these self-care measures:

• Exercise regularly. Regular aerobic exercise, such as walking or swimming, can increase your endurance, keep your body more nimble and help you cope with DISH. Talk with your doctor before starting an exercise program.
• Achieve and maintain a desirable weight. Since obesity is associated with DISH, losing weight may help keep the disease from progressing and lower your risk of complications.
• Apply heat. Use a heating pad on areas of your body that are affected by diffuse idiopathic skeletal hyperostosis to reduce pain. Set the heating pad at a low setting to reduce the risk of burns.

Source: http://www.mayoclinic.com

Risk factors

It isn't clear what causes diffuse idiopathic skeletal hyperostosis, but doctors have some idea of what can increase your risk of the condition. Risk factors include:

• Sex. Men are more likely to develop DISH.
• Older age. DISH is most common in older adults, especially in people older than 50.
• Diabetes and other conditions. People with type 2 diabetes may be more likely to develop DISH than are those who don't have diabetes. Other conditions that may raise insulin levels in your body may also increase your risk, including hyperinsulinemia, prediabetes and obesity.
• Certain medications. Long-term use of medications called retinoids, such as isotretinoin (Amnesteem, Claravis, others), which are similar to vitamin A, can increase your risk of diffuse idiopathic skeletal hyperostosis. It isn't clear whether high intake of vitamin A increases your risk, however.

Source: http://www.mayoclinic.com