DIFFUSE IDIOPATHIC SKELETAL HYPEROSTSIS

Question 1

What is DISH also known as ?

Answer 1

Forestier’s disease.

Question 2

What are the strict radiographic criteria for DISH ?

Answer 2

1) Flowing anterior ossification must involve at least 4 continuous vertebral levels.
2) Bone density is normal
3) Intervertebral disc spaces are normal without narrowing.
4) No involvement of the SI joints - If ankylosis of the SI joints exclude DISH as a differential.

Question 3

What are the clinical presentations of DISH?

Answer 3

Sometimes back pain and stiffness but is usually an incidental finding.

Question 4

What is DISH ?

Answer 4

Bony proliferations at the insertion points of ligaments and tendons.

Question 5

Where is DISH usually seen ?

Answer 5

Lower thoracic region. Less common in Cervical and lumber region.

Question 6

What are the complications of DISH ?

Answer 6

Transverse fractures can result from minor trauma as the anterior aspect is fused.

Question 7

What is the treatment for DISH ?

Answer 7

since incidental is analgesics or may require osteophyte resection in some cases.

Question 8

What can large Osteophytes cause in the neck cause ?

Answer 8

Compression on structures such as inferior Vena Cava and the oesophagus.