Disease Information for Diffuse idiopath.skeletal hyperostosis (DISH)

Clinical Manifestations
Signs & Symptoms
Hip Inner Thigh Pain
Limited chest expansion
Acute Back Pain
Back Pain
Back Pain on Percussion/Spine
Back/Spine/Axial Pain
Bilateral Heel Pain
Cervical spine/neck limited motion
Chronic Back Pain
Hip Pain
Limited spine motion/stiffness
Lumbar spine limited motion
Neck pain
Rigid back posture/spasm
Spinal/Spinal process/tenderness
Spine pain/vertebral skeletal pain
Thoracic spine limited motion
Demographics & Risk Factors
Population Group
Aged Adult
Middle Age Adult
Sex & Age Groups
Population/Adult Aged Only
Population/Elderly Aged
Population/Fifties adult
Population/Middle-aged adult
Population/Seventies Adult
Diagnostic Test Results
CT Scan
MRI/Spine/vertebral STIR sequence
CT/Bone Mineral Density/Increased
Xray/Chest abnormal
Xray/Chest film/extrapulmonary abnormal
Xray/Chest/Lung fields/Abnormal
Xray/Bambooing spine calcifications
Xray/Bone spurs
Xray/Calcification paraspinal ligaments
Xray/Calcification soft tissues
Xray/Flowing anterior-lateral contiguous vertebra/Spine
Xray/Increased bone density
Xray/Ischial tuberosity spurs/calcific tendons
Xray/Nech nuchal ligament calcification
Xray/Ossification of achilles tendon
Xray/Paravertebral calcification/Spine sacrum
Xray/Periarticular calcifications
Xray/Periarticular knee calcifications
Xray/Periarticular whiskering tendon calcific changes
Xray/Quadriceps tendon/anterior patella calcification
Xray/Spine Abnormal
Xray/Spurs fifth metatarsal ligament
Xray/Spurs heel and talus/Enthesiophytes
Xray/Spurs on elbows/ankles/knees
Xray/Symphysis pubis ossification
Associated Diseases & Rule outs
Associated Disease & Complications
Arthritis Axial Skeleton
Diffuse idiopath. skeletal hyperostosis
Heterotopic calcification/hip replacement
Polyarthritis syndrome/Multiple joints/weeks
Enthesopathy Syndrome
Disease Mechanism & Classification
CLASS/Primary organ/system disorder (ex)
CLASS/Ligament involvement/disorder (ex)
CLASS/Axial skeletal involvement/disorder (ex)
CLASS/Cervical spine disorder (ex)
CLASS/Lumbar spine involvement/disorder (ex)
CLASS/Skeletal (category)
CLASS/Thoracic/Dorsal spine involvement/disorder (ex)
Pathophysiology/Enthesopathy insertions/tendons
Pathophysiology/Ligamentous calcification
Pathophysiology/Ligaments calcify not vertebrae/disks
Pathophysiology/Spinal enthesopathy/enthesiophytes
PROCESS/Idiopathic/unclassified/unknown (category)
PROCESS/Enthesopathic arthropathy (ex)
Ankylosing Hyperostoses Vertebral, Ankylosing hyperostosis (Forestier), Ankylosing Hyperostosis Vertebral, Ankylosing verteb hyperostosis, Ankylosing vertebral hyperostosis, Diffuse idiopath skel hyperost, Diffuse idiopathic skeletal hyperostosis, Disease Forestier, DISH, DISH Dif idiop skel hyperost, DISH Diffuse idiopathic skeletal hyperostosis, Disseminated idiopathic skeletal hyperostosis, Disseminated idiopathic skeletal hyperostosis (disorder), Forestier, Forestier and Rotes Querol syndrome, FORESTIER DIS, Forestier Disease, Forestier Rotes Querol syndrome, Forestier's disease, Hyperostoses Vertebral Ankylosing, Hyperostosis Diffuse Idiopathic Skeletal, Hyperostosis Vertebral Ankylosing, Senile ankylosing vertebral hyperostosis, Vertebral Ankylosing Hyperostoses, Vertebral Ankylosing Hyperostosis, Synonym/; Spinal DISH, Synonym/DISH, Synonym/DISH syndrome, Synonym/Forestier's Disease (DISH), Synonym/Senile ankylosing hyperostosis of spine (DISH), Synonym/Skeletal hyperostosis syndrome/DISH, Synonym/Spinal DISH syndrome, Synonym/Spondylitis ossificans ligamentosa (DISH), Synonym/Spondylosis deformans (DISH), Synonym/Spondylosis Hyperostotica (DISH), Synonym/Synonym/Vertebral Ankylosing Hyperostosis (DISH), Synonym/Vertebral osteophytosis. (DISH)
Drug Therapy - Contraindication
SX/Total hip replacement
Drug Therapy - Indication
RX/Non-steroidal anti-inflammatory drugs
Other Treatments
TX/Physical therapy

Diffuse Idiopathic Skeletal Hyperostosis; DISH; Diffuse Idiopathic Skeletal Hyperostosis; Forestier"s Disease ; Spinal DISH; Spinal Diffuse Idiopathic Skeletal Hyperostosis ; Vertebral Ankylosing Hyperostosis ; This disease is also known by other names, including spondylitis ossificans ligamentosa, spondylosis hyperostotica, senile ankylosing hyperostosis of the spine, Forestier"s disease, spondylosis deformans and vertebral osteophytosis;

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease, affects the ligaments around the spine; Sections of the ligaments turn into bone in this disorder, which is considered to be a form of degenerative arthritis; The conversion of ligamental tissue to bone usually extends along the sides of the vertebrae of the spine; (This may be called flowing calcification;) Also, DISH is associated with inflammation (tendinitis) and calcification of the tendons, especially at the points at which the tendon attaches to the bones; When this happens, the patient is said to have developed bone spurs, especially in the heel and ankles (heel spurs); DISH affects three or more vertebrae that are most often located in the chest or in the spine between the chest and pelvis; It is a disorder of older patients, more often affecting men than women ages 50-60; The disorder is often found in association with diabetes, high blood pressure, heart disease and obesity;

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Diffuse idiopathic skeletal hyperostosis (dish) is a disorder of unknown cause characterized by excessive bone fomation at skeletal sites subject to normal or abnormal stresses, generally where tendons and ligaments attach to bone; The spine is the predominant site of involvement, although extraspinal sites may also be affected; Some patients may develop ossification after surgery or in response to coexistent diseases, such as rheumatoid arthritis;;

Three criteria are required to diagnosis spinal involvement in DISH: 1]flowing calcification and ossification along the anterolateral aspect of at least four contiguous vertebral bodies with or without pointed excrescences; 2] relative preservation of intervertebral disc height and absence of extensive changes typical of degenerative disc disease; and3] absence of bone ankylosis of the apophyseal joints or of erosion, sclerosis, or intra-articular osseous fusion of the sacroiliac joints;


External Links Related to Diffuse idiopath.skeletal hyperostosis (DISH)
PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)