Rare Endocrinology News
Disease Profile
Diffuse idiopathic skeletal hyperostosis
Prevalence estimates on Rare Medical Network websites are calculated based on data available from numerous sources, including US and European government statistics, the NIH, Orphanet, and published epidemiologic studies. Rare disease population data is recognized to be highly variable, and based on a wide variety of source data and methodologies, so the prevalence data on this site should be assumed to be estimated and cannot be considered to be absolutely correct.
#N/A
Age of onset
#N/A
ICD-10
#N/A
Inheritance
Autosomal dominant A pathogenic variant in only one gene copy in each cell is sufficient to cause an autosomal dominant disease.
Autosomal recessive Pathogenic variants in both copies of each gene of the chromosome are needed to cause an autosomal recessive disease and observe the mutant phenotype.
X-linked
dominant X-linked dominant inheritance, sometimes referred to as X-linked dominance, is a mode of genetic inheritance by which a dominant gene is carried on the X chromosome.
dominant X-linked dominant inheritance, sometimes referred to as X-linked dominance, is a mode of genetic inheritance by which a dominant gene is carried on the X chromosome.
X-linked
recessive Pathogenic variants in both copies of a gene on the X chromosome cause an X-linked recessive disorder.
recessive Pathogenic variants in both copies of a gene on the X chromosome cause an X-linked recessive disorder.
Mitochondrial or multigenic Mitochondrial genetic disorders can be caused by changes (mutations) in either the mitochondrial DNA or nuclear DNA that lead to dysfunction of the mitochondria and inadequate production of energy.
Multigenic or multifactor Inheritance involving many factors, of which at least one is genetic but none is of overwhelming importance, as in the causation of a disease by multiple genetic and environmental factors.
Not applicable
Other names (AKA)
DISH Forestier's disease; Forestier disease; DISH;
Summary
Diffuse idiopathic skeletal hyperostosis (DISH) is a common skeletal disorder characterized by unusual, new bone formation. The new bone forms most often where ligaments and tendons (connective tissues that connect bones) join bone (entheseal area), but there is also a generalized hardening of bones and bone overgrowth (hyperostosis).[1] Although these changes are most often seen in the spine, DISH can affect almost any part of the skeleton, including hips, knees, ankles, feet, shoulders, hands, and ribs.[2][3] Many people with DISH do not have any symptoms, but in some cases the symptoms get worse over time (progressive) and become quite severe. The most common symptoms are pain, stiffness and reduced range of motion of the neck or upper back.[2][3][4]
DISH is caused by the build up of calcium salts in the tendons and ligaments (calcification) and abnormal new bone growth (ossification) but the reason this happens is unknown. Researchers believe some combination of mechanical, genetic, environmental, and metabolic factors are involved. DISH is more common in people over 50 and in men. While there is no known cure for DISH, there are treatments that can help control symptoms.[1][2][3][4]
Symptoms
- Stiffness
- Pain
- Loss of range of motion
- Tingling, numbness, and/or weakness in the legs
- Spinal fractures and increased risk of breaking other affected bones
- Compressed or pinched nerves (radiculopathy)
- Compressed spinal cord (myelopathy) which can lead to partial or complete paralysis of the legs and/or arms (paraparesis, tetraparesis)
- Difficulty swallowing (
dysphagia ) - Hoarse voice or difficulty speaking (dysphonia)
- Sleep apnea
- Decreased lung capacity (if DISH affects the ribs)
- Difficulty breathing possibly due to airway obstruction
Cause
- Mechanical factors, such as repetitive lifting and moving of heavy objects
- Dietary factors, such as long term exposure to high amounts of Vitamin A
- Medications, such as long term use of synthetic vitamin A products or retinoids, most often used to treat severe acne
- Genetic factors, such as a
genetic predisposition - Metabolic conditions, such as
diabetes mellitus , acromegaly, and obesity - Abnormalities of fat derived
hormones (possibly leptin) and growth hormones
However, even when an increased risk due to a factor is consistently seen in studies, no one factor has been found to cause DISH by itself. Medical researchers therefore believe DISH is caused by several of these factors working together to cause the abnormal bone growth.[1][2][3][4][5]
Diagnosis
Treatment
Even though few studies have focused on indications for surgery, it is generally accepted that surgery is indicated for people with severe symptoms (such as airway obstruction and/or
Organizations
Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.
Organizations Supporting this Disease
-
Arthritis Foundation
1355 Peachtree St. NE
6th Floor
Atlanta, GA 30309
Toll-free: 1-844-571-HELP (4357)
Telephone: +1-404-872-7100
Website: https://www.arthritis.org -
The Arthritis Society
393 University Avenue, Suite 1700
Toronto, Ontario M5G 1E6
Canada
Toll-free: 1-800-321-1433
Telephone: +1-416-979-7228
Fax: +1-416-979-8366
E-mail: [email protected]
Website: https://arthritis.ca/
Social Networking Websites
- Visit the following Facebook groups related to Diffuse idiopathic skeletal hyperostosis:
Forestiers/DISH Research
Forestiers/DISH Support
Learn more
These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.
Where to Start
- The Mayo Clinic Web site provides further information on Diffuse idiopathic skeletal hyperostosis.
In-Depth Information
- Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
- PubMed is a searchable database of medical literature and lists journal articles that discuss Diffuse idiopathic skeletal hyperostosis. Click on the link to view a sample search on this topic.
References
- Pillai S and Littlejohn G. Metabolic Factors in Diffuse Idiopathic Skeletal Hyperostosis – A Review of Clinical Data. The Open Rheumatology Journal. 2014; 8:116-128. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293739/.
- Helfgott SM. Diffuse idiopathic skeletal hyperostosis (DISH). UpToDate. June 7, 2017; https://www.uptodate.com/contents/diffuse-idiopathic-skeletal-hyperostosis-dish.
- Mader R, Verlaan JJ, & Buskila D. Diffuse idiopathic skeletal hyperostosis: clinical features and pathogenic mechanisms. Nat Rev Rheumatol. December 2013; 9(12):741-50. https://www.ncbi.nlm.nih.gov/pubmed/24189840.
- Nascimento FA, Gatto LAM, Lages RO, Neto HM, Demartini Z, & Koppe GL. Diffuse idiopathic skeletal hyperostosis: A review. Surgical Neurology International. 2014; 5(Suppl 3):S122-S125. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4023007/.
- Pappone N, Ambrosino P, Di Minno MN, and Iervolino S. Is diffuse idiopathic skeletal hyperostosis a disease or a syndrome? Need for studies on angiogenesis-stimulating activity. Rheumatology (Oxford). December 24 2016; [Epub ahead of print]:https://www.ncbi.nlm.nih.gov/pubmed/28013194.
- Rothschild BM. Diffuse Idiopathic Skeletal Hyperostosis. Medscape Reference. October 5, 2017; https://emedicine.medscape.com/article/1258514-overview.
- Holgate RL and Steyn M. Diffuse idiopathic skeletal hyperostosis: Diagnostic, clinical, and paleopathological considerations. Clin Anat. October 2016; 29(7):870-7. https://www.ncbi.nlm.nih.gov/pubmed/27004482.
Rare Endocrinology News