Diffuse idiopathic skeletal hyperostosis (DISH)

Diffuse idiopathic skeletal hyperostosis (DISH) is calcification or a bony hardening of ligaments in areas where they attach to your spine.

Also known as Forestier's disease, diffuse idiopathic skeletal hyperostosis may cause no symptoms and require no treatment. The most common symptoms are mild to moderate pain and stiffness in your upper back. DISH may also affect your neck and lower back. Some people experience DISH in other areas, such as shoulders, elbows, knees and heels.

DISH can be progressive. As it worsens, DISH can cause serious complications.

Symptoms Risk factors Complications

You may have no signs or symptoms with DISH. For those who have signs and symptoms, the upper portion of the back (thoracic spine) is most commonly affected. Signs and symptoms may include:

  • Stiffness. Stiffness may be most noticeable in the morning.
  • Pain. You may feel pain in your back or in other affected areas, such as your shoulder, elbow, knee or heel.
  • Loss of range of motion. You may notice this most when stretching side to side.
  • Difficulty swallowing or a hoarse voice. You may experience these if you have DISH in your neck.

When to see a doctor

Make an appointment with your doctor if you have persistent pain or stiffness in any joint or in your back.

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