Diffuse idiopathic skeletal hyperostosis

Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by the calcification or hardening of ligaments and tendons, particularly along the spine.

The term 'idiopathic' means that the exact cause of this condition is unknown.

DISH is most commonly seen in older adults and is more prevalent in men than women.

In individuals with DISH, the most noticeable change is the thickening and hardening of ligaments along the vertebrae of the spine, often leading to a 'flowing' calcification that can be observed in radiologic imaging.

These calcifications primarily affect the thoracic spine but can also be seen in the cervical and lumbar regions.

Unlike other forms of arthritis, DISH does not involve the small joints of the spine but rather the ligaments and the entheses (sites where tendons or ligaments insert into the bone).

Although DISH can be asymptomatic, some individuals may experience stiffness, reduced range of motion, and pain, particularly in the back and neck.

The rigidity in the spine can sometimes lead to complications, such as difficulty swallowing (dysphagia) if the calcification extends to the cervical spine and exerts pressure on the esophagus.

Diagnosis of DISH is typically confirmed through imaging studies such as X-rays, which reveal the characteristic flowing calcifications, but can also be detected through CT scans or MRIs if more detailed images are necessary.

Management of DISH focuses on alleviating symptoms and maintaining mobility.

This often involves physical therapy, pain management, and in some cases, surgical intervention if severe complications arise.

Understanding and addressing lifestyle factors, such as maintaining a healthy weight and engaging in regular exercise, can also help manage the condition's progression.