Diffuse Idiopathic Skeletal Hyperostosis (DISH) � a  Rare Presentation of the Disease

Dr. Dodia Apoorva V; Dr. Pratik D. Shah; Dr. Soman Shardul M.

Volume : III, Issue : VIII, August - 2013

Diffuse Idiopathic Skeletal Hyperostosis (DISH) � a Rare Presentation of the Disease

Dr. Dodia Apoorva V, Dr. Pratik D. Shah, Dr. Soman Shardul M.

Abstract :

Diffuse idiopathic skeletal hyperostosis (DISH) also known as Forestier’s disease, is a disorder of unknown etiology that is characterized by back pain and spinal stiffness. The condition is recognized radiographically by the presence of "flowing" ossification along the anterolateral margins of at least four contiguous verteae (candle wax dripping appearance) and the absence of changes of spondyloarthropathy or degenerative spondylosis. Even in patients who present with either lumbar or cervical complaints, radiographic findings are almost universally seen on the right side of the thoracic spine. It is characterized by a tendency toward ossification of ligaments (enthesopathy). It most characteristically affects the spine. Ossification of the longitudinal ligaments (especially the anterior ligaments) of the spine produces a tortuous paraverteal mass anterior to and distinct from the verteal bodies. The zygapophyseal and sacroiliac joints are not involved in DISH, and the intervening interverteal disk space is preserved. But our patient presented with hip and knee pain rather than the usual spine complaints.