diffuse idiopathic skeletal hyperostosis

Common Signs and Symptoms of Diffuse Idiopathic Skeletal Hyperostosis (DISH)

Diffuse idiopathic skeletal hyperostosis (DISH) is a type of arthritis that causes your soft tissues to harden, making you stiff and sore. The symptoms of DISH can vary from person to person, but here are some common signs and symptoms:

• Stiffness: Stiffness is usually worse in the morning or evening, making it difficult to move around.
• Pain: Pain, especially in your neck or upper back (cervical or thoracic spine), is a common symptom of DISH. You may also experience pain in other areas such as shoulders, elbows, knees, or heels.
• Limited Range of Motion: As the ligaments and tendons harden, it can lead to limited range of motion in your joints, making everyday activities more challenging.

According to various medical sources [1][3], symptoms of DISH may also include:

• Mild to moderate pain and stiffness in your upper back
• Thoracic and lumbar involvement
• Mild chronic back pain
• Stiffness that's usually worse in the morning or evening

In some cases, DISH can cause more severe symptoms such as dysphonia (voice changes), weight loss, odynophagia (painful swallowing), reflux disease, snoring, aphonia (loss of voice), choking, and pharyngeal perforation [6].

It's essential to consult a healthcare professional for an accurate diagnosis and treatment plan if you're experiencing any of these symptoms.

References:

[1] Context result 3: Symptoms of DISH include ongoing or repeated back pain and decreased range of motion, particularly in the morning or after long periods of inactivity. [2] Context result 5: What are the symptoms of DISH? · stiffness, usually in the morning or evening · back pain, especially in your upper back · shoulder, elbow, knee or heel pain · pain ... [3] Context result 7: Symptoms ... thoracic and lumbar involvement ... mild chronic back pain ... usually pain is minimal because of stabilization of spinal segments ... [4] Context result 8: Oct 20, 2020 — If it does cause symptoms, the most common are mild to moderate pain and stiffness in your upper back. DISH can also affect your neck and lower ... [5] Context result 6: by R Terzi · 2014 · Cited by 33 — MISCELLANEOUS SYMPTOMS​​ Other symptoms of DISH include dysphonia, weight loss, odynophagia, reflux disease, snoring, aphonia, choking, pharyngeal perforation, ...

Diffuse idiopathic skeletal hyperostosis (DISH) can be diagnosed through various imaging tests, which are essential in confirming the condition.

• X-rays: A routine X-ray is often the first imaging test used to diagnose DISH. It can show characteristic signs of the condition, such as flowing bridging anterior vertebral osteophytes and enthesopathy around the spine [7][10].
• Computed Tomography (CT) scans: CT scans can provide more detailed images than X-rays and are often used to confirm the diagnosis of DISH, especially in cases where there is concern for a fracture following low-energy trauma [3][6].
• Magnetic Resonance Imaging (MRI): While MRI is not typically used to diagnose DISH, it may be useful in ruling out other conditions that can cause similar symptoms.
• Ultrasonography: Ultrasonography of peripheral entheses can also be used to diagnose DISH, particularly in cases where the condition affects the spine and peripheral sites [5].

It's worth noting that a diagnosis of DISH is often made based on a combination of clinical findings and imaging test results. A thorough physical exam and medical history are essential in confirming the diagnosis.

References: [1] Mader R, Novofastovski I, Iervolino S, et al. Ultrasonography of peripheral entheses in the diagnosis and understanding of diffuse idiopathic skeletal hyperostosis (DISH). [5] [3] Colin Woon MD. Topic Podcast. DISH (Diffuse Idiopathic Skeletal Hyperostosis) [3] [6] Lantsman B, et al. Whole-spine computed tomography (CT) is mandatory in patients with DISH who have experienced low-impact trauma. [6] [7] H Misaki. Diagnosis of diffuse idiopathic skeletal hyperostosis based on anterior longitudinal ligamental ossification in the lumbar spine using plain lumbar spine X-ray images. [8] [10] A Patient's Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH) Compliments of: Introduction [13]

Differential Diagnosis of Diffuse Idiopathic Skeletal Hyperostosis (DISH)

Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic non-inflammatory disease characterized by ossification and calcification of ligaments and entheses. When diagnosing DISH, it's essential to consider differential diagnoses that may mimic its clinical presentation.

Conditions to Consider:

• Ankylosing Spondylitis (AS): A chronic inflammatory rheumatic disease that affects the spine and other joints. While AS is relatively rare, with a prevalence of 0.05-1.4%, it's crucial to distinguish it from DISH due to their similar radiological features.
• Spondylosis Deformans: A degenerative condition characterized by bony growths on the vertebrae, which can be mistaken for DISH.
• Reactive Arthritis: A type of arthritis that occurs as a reaction to an infection elsewhere in the body. It may present with similar symptoms to DISH.
• Psoriatic Arthritis: A form of arthritis associated with psoriasis, which can also mimic the clinical presentation of DISH.

Key Differences:

• Age and Sex: AS typically affects young white males, whereas DISH is more common in older individuals.
• Radiological Features: While both conditions share similar radiological features, such as calcification and ossification of ligaments and entheses, the aspect of these bone proliferations can differ. AS often presents with syndesmophytes (thinner, more delicate bony growths), whereas DISH is characterized by larger, more bulky bony excrescences.
• Clinical Presentation: Patients with AS are usually symptomatic, with complaints of pain and stiffness, whereas those with DISH may be asymptomatic or present with mild symptoms.

Diagnostic Approach:

To accurately diagnose DISH, healthcare providers should consider a thorough physical examination, imaging tests (such as x-rays, CT scans, or MRIs), and laboratory studies. A detailed medical history and review of systems can also help differentiate DISH from other conditions.

By considering these differential diagnoses and key differences, healthcare providers can make an accurate diagnosis of diffuse idiopathic skeletal hyperostosis (DISH) and provide appropriate management and treatment.

References:

• Resnick et al. (1975)
• Resnick et al. (2013)
• Kim et al. (2017)
• Lee et al. (2020)

Note: The references provided are based on the information within the search results and may not be an exhaustive list of relevant studies or publications.