Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Diffuse idiopathic skeletal hyperostosis (DISH) is a condition that causes bone to form in abnormal
places. DISH most commonly affects the mid back (thoracic spine) but may also
affect the neck (cervical spine), low back (lumbar spine), hips, heels, and other
areas. DISH is also known as Forestier's disease, spondylitis ossificans
ligamentosa, spondylosis hyperostotica, and ankylosing hyperostosis of the spine.
The exact cause of DISH is not known. DISH is more common in men than women and
the elderly. DISH is uncommon before age 40. Decreased range of motion of the
spine, especially in the mid back, is the most common sign of DISH. The
diagnosis of DISH is made using X-rays. The treatment of DISH involves treating
each bothersome symptom, if there are any.
Diffuse Idiopathic Skeletal Hyperostosis Causes
The exact cause of DISH is
not known. A variety of factors are thought to contribute to its development,
such as metabolic conditions. For example, DISH is more common in obese people
and those with diabetes, as well as up to 20% of people with acromegaly (a rare
condition caused by abnormal levels of growth hormone). It is more common in men
than women and the elderly. DISH is uncommon before age 40.
Diffuse Idiopathic Skeletal Hyperostosis Symptoms and Signs
of motion of the spine, especially in the mid back, is the most common sign of
DISH. DISH commonly causes pain in the affected area. For example, neck pain is
common in people with DISH in the cervical spine (the spine in the neck).
If large bone spurs form in the neck, they can rarely cause difficulty
breathing or trouble swallowing. Very rarely, large bone spurs in the neck or
elsewhere in the spine can cause serious complications due to compression of the
spinal cord. Bone spurs in the low back can put pressure on the spinal nerves
and cause numbness and tingling in the legs.
Other signs of DISH include tenderness over sites where ligaments attach to
bones, such as the back of the heel where the Achilles tendon attaches to bone.
The symptoms of DISH can be
similar to those seen in other diseases affecting the spine or sites where
tendons attach to bone including degenerative disc disease, degenerative spondylosis, ankylosing spondylitis, spondylolisthesis, spondyloarthropathy, and
Diffuse idiopathic skeletal hyperostosis (DISH) is a disorder in which there is bone growth in the ligaments, particularly where they attach to the bones of the spine. You may have no symptoms, or you could have relatively minor spinal stiffness and pain. Over time your spine will stiffen and your vertebrae may fuse together.