Diffuse idiopathic skeletal hyperostosis clinical aspects

Abstract

Background. Diffuse idiopathic skeletal hyperostosis (DISH) is a rheumatologic condition characterized by ossification of the spinal ligaments and tendons with unknown etiopathology. DISH primarily affects the elderly. The presence of DISH may indicate underlying metabolic derangement and is associated with cardiovascular disease, obesity, osteoarthritis, diabetes mellitus. Objective of the study. evaluated the clinical aspects of DISH. Material and methods. Through the PubMed, NCBI, NIH databases Rheum and Science Direct 50 publications were selected. Results. DISH may present with no symptoms or with impaired status. Bone depositions with formation of obstructive masses may lead to biomechanical changes of the musculoskeletal system and/or the multiorgan implication. Clinical symptoms include a large variety of complains morning stiffness, spinal pain, radiculopathy, myelopathy, para-, tetra paresis, decrease lung capacity with airway obstruction, dysphagia, dysphonia, rhinolalia due to irritation of the recurrent laryngeal nerve, imprisonment syndromes may occur. Mild impact trauma may provoke fractures. Older age, male sex, obesity, hypertension, atherosclerosis, diabetes mellitus has all been linked to the prevalence of DISH. The disease can cause severe complications. Early diagnosis and prophylaxis are important. Imaging methods are the priority in visualizing extensive bone proliferation. Conclusions. Because the disease evolves for a long time asymptomatically or with minor symptoms, patients in the at-risk group require increased medical and personal vigilance. Imaging examinations (X-ray, computed tomography) and prophylactic treatment to control the pathological bone proliferation process are important.