Diffuse idiopathic skeletal hyperostosis (DISH) is a condition that causes bone to form in abnormal places. DISH most commonly affects the mid back but may also affect the neck, low back, hips, heels, and other areas. DISH is also known as Forestier's disease, spondylitis ossificans ligamentosa, spondylosis hyperostotica, and ankylosing hyperostosis of the spine. 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 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 spinalarthritis.
The treatment of DISH should be individualized for the patient and their specific signs and symptoms. Physical activity and physical therapy are usually beneficial for patients suffering from spinal stiffness. For example, stretching and gentle exercise generally help with stiffness. Formal physical therapy can include assistance with the appropriate stretching and exercises, as well as modalities such as ultrasound. For those patients with pain that does not respond to exercise and physical therapy, acetaminophen (Tylenol) and NSAIDs (non-steroidal anti-inflammatory drugs) are frequently very beneficial.