Symptoms and Signs of Diffuse Idiopathic Skeletal Hyperostosis (DISH)

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Medically Reviewed on 7/27/2021

Doctor's Notes on Diffuse Idiopathic Skeletal Hyperostosis (DISH)

Diffuse idiopathic skeletal hyperostosis (DISH) (also called also known as Forestier's disease, spondylitis ossificans ligamentosa, spondylosis hyperosmotic, and ankylosing hyperostosis of the spine) is a hardening of ligaments that causes the bone to form in abnormal places. DISH most commonly affects the mid-back (thoracic spine) but it can also affect the neck (cervical spine), lower back (lumbar spine), hips, heels, and other areas. 

Symptoms of diffuse idiopathic skeletal hyperostosis include decreased range of motion of the spine (especially in the mid-back) and pain in the affected area. If large bone spurs form in the neck, in rare cases they may 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 symptoms of diffuse idiopathic skeletal hyperostosis (DISH) include tenderness over sites where ligaments attach to bones.

What Is the Treatment of Diffuse Idiopathic Skeletal Hyperostosis (DISH)?

There is no treatment available that can cure DISH. Available treatments are aimed at improving symptoms, increasing comfort, and reducing the severity of complications. Treatment may consist of:

  • Pain-relieving medications such as acetaminophen or ibuprofen
  • Corticosteroid injections
  • Warm compresses
  • Physical therapy or exercises to increase mobility
  • Muscle relaxant medications, in some cases
  • Surgery, in uncommon cases in which the abnormal bone may cause severe complications such as difficulty swallowing or breathing

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.