Diffuse Idiopathic Skeletal Hyperostosis (DISH)

The diffuse idiopathic skeletal hyperostosis, commonly known as DISH, is a condition characterized by the ossification of ligaments, particularly where they attach to the spine. This disease does not always cause symptoms, and in many cases, medical intervention is not necessary. When DISH does produce symptoms, the most characteristic complaints include moderate pain and stiffness, primarily in the upper back. In addition, the disease may also affect the neck and lower back, and in some cases, it can manifest in other areas such as the shoulders, elbows, knees, and heels.

DISH is progressive, meaning it can worsen over time, leading to serious complications. Early detection and treatment of the disease are important to avoid potential complications. The appearance and severity of DISH symptoms can vary from person to person, so it is advisable to pay attention to the signals our body sends.

DISH is not only associated with physical symptoms but can also affect our quality of life, making it important to be aware of the possible signs and risk factors of the disease.

Symptoms and Disease Detection

In the case of DISH, many individuals do not experience immediate symptoms, allowing the disease to remain unnoticed for a long time. However, when symptoms do appear, the upper back is most commonly affected, where the following complaints may occur:

Stiffness is most pronounced in the morning, making it difficult for those affected to move, and initiating physical activity can be particularly uncomfortable. Pain is also characteristic, which may occur in the back, shoulders, elbows, knees, or heels. Affected individuals often experience a decrease in range of motion, especially during lateral movements.

If DISH also affects the cervical spine, difficulties in swallowing and a hoarse voice may occur, which can develop as a result of bony growths. It is important to consult a doctor if we experience persistent pain or stiffness in any joint, to receive the appropriate diagnosis and treatment.

Causes of DISH Development

The exact causes of DISH are currently unknown, but the condition is associated with the accumulation of calcium salts in ligaments and tendons and the hardening of bones. Researchers have identified several risk factors that may contribute to the development of DISH.

One of the most significant risk factors is gender, as the disease occurs more frequently in men. Additionally, older age is a significant factor, as DISH is most commonly observed in older adults. Diabetes also increases the risk of the disease, as conditions associated with high insulin levels, such as hyperinsulinemia, may contribute to the development of DISH.

Certain medications, such as retinoids, which are used to treat various skin disorders, may also increase the risk of DISH. When using medications long-term, it is advisable to monitor for possible side effects and consult a doctor.

Possible Complications and Consequences

Individuals suffering from DISH may develop various complications that can significantly impact their quality of life. One of the most common consequences is limited mobility, which can arise due to the hardening of bones and decreased range of motion. For example, if the shoulder is affected, using the arm can become more difficult, posing a significant obstacle in daily activities.

Difficulties in swallowing are also common complications, especially if bony growths affect the cervical spine. These growths can exert pressure on the esophagus, leading to hoarseness or even swallowing problems. In rare cases, DISH can lead to more severe complications that may require surgical intervention.

The risk of spinal fractures also increases, particularly in cases of moderate to severe DISH. Even minor injuries can cause fractures that may require surgical treatment. Therefore, early detection and treatment of the disease are crucial to avoid more serious health problems.