Diffuse idiopathic skeletal hyperostosis (DISH) – A case report

Abstract

Diffuse idiopathic skeletal hyperostosis is a non inflammatory systemic disease affecting axial skeleton which results in ossification and calcification of spinal ligaments and entheses. The pathophysiology of the disease is poorly understood. The closest differential diagnosis for DISH remains ankylosing spondylitis. Further research is necessary to treat the disease and to improve the prognosis and quality of life of patients affected with DISH. This article reports a patient with DISH and its management in a tertiary care hospital.

Anterior cervical osteotomy of diffuse idiopathic skeletal hyperostosis lesions with computer‐assisted navigation surgery: A case report

“…Often an incidental finding on imaging, DISH diagnosis relies on specific clinical criteria 16 . In the cervical spine, DISH‐related osteophytes can compress pharyngeal and esophageal structures, leading to dysphagia for which clear surgical guidelines remain limited 1–9 . Moreover, individuals with DISH are at an increased risk of fractures through the disc space or vertebral body 17 .…”

“…DISH in the cervical spine is frequently asymptomatic and until recently had unclear diagnostic criteria. Consequently, the disease has been underdiagnosed and understudied 1–6 . When DISH lesions are present in the cervical spine, symptoms typically manifest in males over 50 and commonly include dysphagia, dysphonia, dyspnea, cervical spine pain, and neurological signs 1,2,5–9 .…”

“…adopted a multi‐center approach to determine DISH surgical indications, and suggested targeted bone resections for elderly DISH patients, whereas younger patients with DISH may necessitate broader decompressions. However, existing literature on surgical treatment for DISH primarily consists of case reports 3,8,9 …”

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Diffuse Idiopathic Skeletal Hyperostosis (DISH), also known as Forestier disease, is a skeletal condition characterized by ossification of ligaments, tendons, and entheses near the cervical and thoracic vertebrae, with a prevalence ranging from 4% to 42% depending on the study population. [1][2][3][4] DISH in the cervical spine is frequently asymptomatic and until recently had unclear diagnostic criteria. Consequently, the disease has been underdiagnosed and understudied.

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“…However, existing literature on surgical treatment for DISH primarily consists of case reports. 3,8,9 Computer-assisted navigation (CAN) is an established tool in spine surgery, enabling pre-and intraoperative spinal imaging registration to provide immediate visual…”