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Filmmaker John Christensen was in Seattle when he discovered a business that pulsed with enthusiasm and commitment. It was the World Famous Pike Place Fish Market, where large crowds come to watch the fishmongers work—and buy lots of fish. Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by abnormal calcification/bone formation (hyperostosis) of the soft tissues surrounding the joints of the spine, and also of the peripheral or appendicular skeleton. In the spine, there is bone formation along the anterior longitudinal ligament and sometimes the posterior longitudinal ligament, which may lead to Specialty: Rheumatology.
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The facet and sacroiliac joints tend to be uninvolved. The thoracic spine is the most common level involved. The majority of people with DISH are not symptomatic,  and the findings are an incidental imaging abnormality.
The exact cause is unknown. Mechanical, dietary factors and use of some medications e. There is a correlation between these factors but not a cause or effect.
The distinctive radiological feature of DISH is the continuous linear calcification along the antero-medial aspect of the thoracic spine. DISH is usually found in people in their 60s and above, and is extremely rare in people in their 30s and 40s. The disease can spread to any joint of the body, affecting the neck, shoulders, ribs, hips, pelvis, knees, ankles, and hands.
The disease is not fatal; however, some associated complications can lead to death. Complications may include paralysis, dysphagia difficulty swallowing , and lung infections. Although DISH manifests in a similar manner to ankylosing spondylitis , they are separate diseases.
Ankylosing spondylitis is a genetic disease with identifiable marks, tends to start showing signs in adolescence or young adulthood, is more likely to affect the lumbar spine, and affects organs.
DISH has no indication of a genetic link, is primarily thoracic and does not affect organs other than the lungs, and only indirectly due to the fusion of the rib cage.
Long term treatment of acne with vitamin derived retinoids , such as etretinate  and acitretin,  have been associated with extraspinal hyperostosis.
DISH is diagnosed by findings on x-ray studies. Radiographs of the spine will show abnormal bone formation ossification along the anterior spinal ligament. The disc spaces, facet and sacroiliac joints remain unaffected. Diagnosis requires confluent ossification of at least four contiguous vertebral bodies.
The calcification and ossification is most common on the right side of the spine. In people with dextrocardia and situs inversus this calcification occurs on the left side. Confluent ossification of multiple contiguous vertebral bodies in diffuse idiopathic skeletal hyperostosis DISH.
Note the preponderance on the patient's left side right side of image. Ossification of the posterior longitudinal ligament in DISH. Symptoms of pain and stiffness may be treated with conservative measures, analgesic medications such as non-steroidal anti-inflammatory drugs , and physical therapy. In extraordinary cases where calcification or osteophyte formation is causing severe and focal symptoms, such as difficulty swallowing or nerve impingement, surgical intervention may be pursued.
From Wikipedia, the free encyclopedia. Redirected from Diffuse Idiopathic Skeletal Hyperostosis. Medical condition. Ectopic calcification and new bone formation in diffuse idiopathic skeletal hyperostosis DISH. June ISSN PMID Essentials of Musculoskeletal Care 4 ed.
ISBN Nature Reviews Rheumatology. Seminars in Arthritis and Rheumatism. Clinics in Rheumatic Diseases. Clinical features and functional status". Frontiers in Surgery. ISSN X. PMC Surg Neurol Int. Clinical Orthopaedics and Related Research. The New England Journal of Medicine. Journal of the American Academy of Dermatology. Cambridge University Press, , p. Clinical Rheumatology. The Laryngoscope.
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Views Read Edit View history. Help Learn to edit Community portal Recent changes Upload file. Download as PDF Printable version. Wikimedia Commons. Forestier's disease, senile ankylosing spondylosis, ankylosing hyperostosis. Wikimedia Commons has media related to Diffuse idiopathic skeletal hyperostosis.