Diffuse Idiopathic Skeletal Hyperostosis
Overview
Diffuse Idiopathic Skeletal Hyperostosis (DISH), also known as Forestier’s Disease, is a condition that causes some of the ligaments and tendons in the body to become calcified. It is somewhat common in the elderly population, primarily affecting those over the age of 50 and is more prevalent among men than women. It often affects the spine and can lead to stiffness and reduced mobility.
Types
While DISH often affects the spine, particularly the thoracic spine (middle of back), it can also impact other parts of the body including the neck, upper back, lower back, and even the peripheral areas like the hands and legs. It can be broadly categorized based on the areas impacted:
1. Spinal DISH: This is the most common form, affecting the spinal column, leading to stiffness, pain, and reduced mobility.
2. Peripheral DISH: It invades areas such as the hands, knees, hips, or feet. Its symptoms may resemble arthritis.
Causes
The specific causes of DISH are unknown. However, a range of risk factors are believed to increase the likelihood of developing this condition. These include:
– Age: DISH is more common in older adults, especially those over 60 years of age.
– Gender: Men are more prone to DISH than women.
- Obesity: The condition is often associated with metabolic syndromes, such as obesity and diabetes.
– Certain medications: Prolonged use of medications, like isotretinoin, used to treat skin conditions, can increase the risk.
Symptoms
Symptoms of DISH can vary greatly among individuals. Some people may experience no symptoms (asymptomatic) while others may experience one or more of the following:
– Stiffness, particularly noticeable in the morning
– Pain along the affected area, which improves with activity
– Difficulty swallowing (dysphagia) or a hoarse voice, in cases where the neck is affected
Diagnosis
Diagnosing DISH can be a complex process as its symptoms often resemble other conditions. The condition is usually detected through X-rays or computed tomography (CT) scans which can reveal the distinctive “flowing” calcification along the ligaments and tendons of the spine. Doctors might also carry out a physical examination and evaluate the patient’s medical history.
Treatment Options
While there is no known cure for DISH, treatments are aimed at managing the symptoms and improving quality of life. These include:
– Medication: Over-the-counter pain relievers or nonsteroidal anti-inflammatory drugs (NSAIDs) can help ease pain and inflammation.
– Physical Therapy: Regular exercise and physical therapy can help enhance flexibility and reduce stiffness.
– Surgery: In rare situations, if DISH progresses to causing difficulty swallowing or breathing, a surgeon might remove the excess bone growth.
Living With Diffuse Idiopathic Skeletal Hyperostosis
Living with DISH can be easier with a few adjustments:
– Regular Exercise: Gentle exercise can maintain flexibility and strength, and reduce stiffness. Always consult a physical therapist for an exercise routine suited to your condition.
– Weight Management: Since obesity is a risk factor, managing one’s weight can be beneficial.
– Regular Check-ups: Regularly visiting the doctor will help track the disease and adapt the treatment as needed.
When to Seek Help
While DISH can often be managed at home, there are certain situations that require immediate medical attention. These include:
– Persistent or worsening pain
– Numbness or weakness in the limbs
– Difficulty swallowing or breathing.
In such cases, contact your healthcare provider immediately to prevent complications. Living with DISH might be challenging but with the right treatment and lifestyle changes, symptoms can be managed effectively.
