Diffuse idiopathic skeletal hyperostosis


Diffuse idiopathic skeletal hyperostosis (DISH) is a condition that results in the calcification of body ligaments and tendons around the spine. This disorder is a type of arthritis that is also known as Forestier’s disease.

These calcified regions can also develop bone spurs, which are abnormal new bone growths that can cause pain, stiffness, and restrict mobility. This typically happens where the tissue and bone are connected.

The thoracic and cervical spine, which make up the upper section of the back and neck, are frequently affected by DISH. DISH can occur anywhere on the body such as hands, knees, hips, heels, and/or ankles.

The management of DISH can involve a range of approaches such as physical therapy, medication, surgery, and the use of heat therapy.


Some DISH patients have no symptoms. X-rays obtained for a different purpose are examined by doctors who find the condition. When DISH symptoms do manifest, they include:

  • Stiffness that is common in the morning or evening
  • Numbness or tingling sensation in the legs
  • Weakness in the legs
  • Pain at the upper back or neck
  • Pain in the shoulder, elbows, knees, or heels
  • Reduced mobility or loss of range of motion
  • Difficulty swallowing or hoarseness (abnormal voice changes) if DISH affects the neck.

Symptoms typically appear when the spine’s surrounding nerves start to be compressed by bone spurs.


DISH is brought on by abnormal bone growth and calcification. An accumulation of calcium salts causes calcification, which results in the hardening of ligaments and tendons. What triggers these conditions is unknown to healthcare providers.

Risk Factors

There are some risk factors that are believed to increase the likelihood for DISH even though the cause is unknown. They consist of:

  • Age: People who are 50 and older are at risk to develop DISH. DISH is uncommon for people who are under the age of 40.
  • Gender: It is common for men than women.
  • Medication: Retinoids, such as those used to treat severe acne, can make someone more susceptible to getting DISH.
  • Other diseases: DISH may occur from conditions that alter the metabolism of cartilage, such as diabetes mellitus (high blood sugar) and acromegaly (excessive growth hormone in the body). Have experienced prolonged exposure to high quantities of vitamin A.