DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS

Diffuse idiopathic skeletal hyperostosis (DISH) is otherwise known as Forestier’s disease. This condition is a type of arthritis that affects the tendons and ligaments which are mainly attached to the spine. This medical condition is caused by calcification and ossification, and hyperostosis. 

The calcification refers to the build-up of calcium salts in the ligaments and the tendons. On the other hand, ossification and hyperostosis are the abnormal growth of new bone (bone spurs). 

People with this medical condition do not have a shorter lifespan. But, they have a higher risk of several medical complications that includes the following:

  • Disability

The loss of range in motion in the affected joints does not allow the person to move certain areas.

  • Chronic Pain
  • Dysphagia
  • Bone spurs or DISH affecting the neck causes pressure in the esophagus. This DISH leads to the difficulty of swallowing and breathing while sleeping.

If this condition affects the ligaments, specifically the posterior longitudinal ligament, it causes pressure in the spinal cord. Too much compression of the spinal cord may eventually result in loss of feeling or paralysis.

SYMPTOMS

The dish may affect many parts of the skeleton, including the hips, ankle, knee, feet, hands, ribs, and shoulders. Many people infected with this disease do not suffer from its symptoms. However, this may become progressive and has the chance of getting worse over time.

As stated in many studies, diffuse idiopathic skeletal hyperostosis usually does not have symptoms. However, individuals affected with this condition may commonly suffer symptoms in the back and neck. It can also be in the ankle, feet, hands, ribs, shoulders, and ribs. Symptoms include pain, tingling, numbness, weakness in the legs, dysphagia, dysphonia, radiculopathy, sleep apnea, decreased lung capacity, stiffness, and range in motion, myelopathy, and difficulty breathing due to obstruction in the airways.

DIAGNOSIS

Often, people suffering from diffuse idiopathic skeletal hyperostosis may consult a doctor upon feeling the symptoms. To medically conclude if the person suffers from the condition, an X-Ray must be conducted. X-ray is the tool to diagnose the condition. 

For some patients, magnetic resonance imaging or a computed tomography is an imaging technique ordered by a physician to diagnose the condition safely. X-ray, magnetic resonance imaging, and computed tomography is the machinery that helps determine the skeleton area affected by the condition, DISH.

TREATMENT

The treatment for this condition mainly focuses on the symptoms felt by the person affected by this condition. Pain associated with diffuse idiopathic skeletal hyperostosis is treated with pain relievers and non-steroidal anti-inflammatory drugs, including ibuprofen. 

For severe pain, corticosteroid injections may be used as treatment and other muscle relaxants. Physical therapy and exercise are also recommended to reduce stiffness and increase the joints’ range of motion. 

The surgery is only recommended for a patient who is experiencing severe symptoms. If medication and therapy fail, then patients who experience airway obstruction and difficulty swallowing are advised to have surgery.

Currently, support organizations are present to assist individuals who are suffering from this medical condition.

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