From the Research
Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a condition characterized by abnormal bone growth along the sides of the vertebrae of the spine, primarily affecting older adults, typically over age 50, and is more common in men, as reported in the most recent study 1.
Key Features of DISH
- The main feature is calcification and ossification of ligaments, particularly along the right side of the spine, creating a flowing pattern of bone formation that resembles melted candle wax on X-rays.
- Symptoms may include stiffness, limited range of motion in the affected area, and mild to moderate pain, though some people remain asymptomatic.
- Dysphagia is a rare presentation of this entity, observed in only 0.6-1.0% of the cases, and may require surgical intervention, as seen in a case report 1.
Diagnosis and Treatment
- Diagnosis of DISH requires at least two or three contiguous intervertebral bridges, without severe disk alterations or ankylosis of the sacroiliac or facet joints, as stated in a study 2.
- Treatment focuses on symptom management through non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, physical therapy to maintain mobility, and weight management to reduce stress on the spine.
- In severe cases where the condition affects swallowing or breathing, surgical intervention may be necessary, as reported in a case study 1.
Associated Conditions
- DISH is associated with an increased risk of metabolic syndrome, with an odds ratio of 3.88, as found in a study 2.
- Research into the pathophysiology of DISH has established that serum levels of the natural osteogenesis inhibitor Dickkopf-1 (DKK-1) are low in patients with DISH or spondylarthritis, although this abnormality might contribute to the entheseal ossification, it has not been found consistently, as reported in a study 2.