Diffuse Idiopathic Skeletal Hyperostosis (DISH): Forestier's Disease with Extraspinal Manifestations

Abstract

The extraspinal manifestations of Forestier's disease are described in 21 consecutive cases; diffuse idiopathic skeletal hyperostosis (DISH) is suggested as a more appropriate description of this ossifying diathesis. Characteristic roentgen abnormalities of the spine were present in all individuals and associated with significant axial clinical complaints. In extraspinal locations, hyperostosis at ligament attachments usually occurs in the pelvis, calcaneus, tarsal bones, ulnar olecranon and patella, and is occasionally associated with clinical signs and symptoms requiring surgery. The radiographic appearance in the peripheral skeleton is frequently distinctive and allows the radiologist to suggest the correct diagnosis, even in the absence of axial radiographs.

Osteogenic lineage commitment of mesenchymal stem cells from patients with ossification of the posterior longitudinal ligament

“…In OPLL patients, ectopic ossification occurs throughout the spine, frequently involving ossification of other spinal ligaments. Consequently, OPLL has been regarded as one of the manifestations of diffuse idiopathic skeletal hyperostosis (DISH) [5,6]. Based on genetic factors, these current findings may indicate that OPLL patients would have a tendency toward systemic ossification of numerous ligaments, similar to that observed in patients with DISH.…”

Anterior Cervical Osteophytes Causing Dysphagia and Dyspnea: An Uncommon Entity Revisited

“…Hypertrophic anterior cervical osteophytes (HACO) occur in degenerative disc disease, as part of the physiologic or accelerated aging process, or in diffuse idiopathic skeletal hyperostosis (DISH), also known as ForestierÕs disease [1,2]. Voluminous HACO can compress the pharyngoesophageal and the laryngotracheal segments causing dysphagia.…”

“…Voluminous HACO can compress the pharyngoesophageal and the laryngotracheal segments causing dysphagia. The incidence of dysphagia in patients with HACO or DISH ranged from 0.2% to 28% [1,3,4]. Dyspnea caused by HACO is less common.…”

Cervical myelopathy caused by soft-tissue mass in diffuse idiopathic skeletal hyperostosis

“…DISH of the cervical spine affects the lower region between C4 and C7 much more than the upper region between C1 to C3. A study of 68 patients with cervical DISH showed only 10.2% manifestation at C1 and segmental motion of atlantoaxial joint was preserved in 90% of the patients [20,21].…”