Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a condition where there is a bony hardening of ligaments. Mostly it occurs in areas where the ligament is attached to the spine but sometimes it also affects areas of the elbow, knee, heels, and shoulder. This is a progressive condition and as the disease progresses the complications can be severe.
Read about the bones and joints disorders
Symptoms of Forestier’s Disease:
- Stiffness of joints especially in the morning.
- Pain in the affected areas.
- Loss of range of motion especially while stretching.
- Difficulty in swallowing with hoarseness in voice is seen in cases where the neck is affected.
- Increased risk of spinal fracture
- Sleep apnea
- Difficulty in breathing due to obstruction in the airways.
Causes
The exact cause of the disease is yet to be proven, but it is thought that the following causes result in hyperostosis of the ligament:
- Repetitive lifting and moving heavy objects
- Long-time exposure to high amounts of Vitamin A
- Family history
- Obesity
- Acromegaly
- Diabetes
Diagnosis of Forestier’s Disease
Diagnosis is often suspected by the signs and symptoms exhibited by the person. However, an X-ray is done to confirm the diagnosis. In some cases where X-ray also does not confirm the diagnosis then CT scan or MRI is done to confirm the diagnosis. All three types of imaging are studied to know which other skeletal parts are also in the process of undergoing hyperostosis.
Risk factors
- Men are at higher risk of developing this ailment than women.
- Older adults are at higher risk. Mostly seen in people post 50 years of age.
- People suffering from diabetes are more likely to develop this ailment.
- Long -term use of the Vitamin A supplement.
- Overexposure of vitamin A for a long time.
Complications of Forestier’s disease:
People who suffer from diffuse idiopathic skeletal hyperostosis are likely to suffer from the following complications:
- Disability as most of the ligament ossifies progressively with time.
- Due to bone spurs in the neck, people can suffer from hoarse voice and even difficulty in swallowing.
- Increased risk of fracture.
Lifestyle modifications to relief symptoms:
- Swimming is a very good exercise for people suffering from diffuse idiopathic skeletal hyperostosis as it improves stiffness and range of motion of joints without risk of injury.
- Heat application to reduce early morning stiffness of joints.
- Keep weight and blood sugar levels in control.
- Special shoe inserts to prevent bone spurs from the heel to hurt while walking.
When to see a doctor?
See a doctor if you experience pain and stiffness in joints especially neck early morning.
Repetitive Strain Injury