Causative & risk factors
The exact cause of DISH is not known. However the common patient profile is that of a male older than 50 years.
Obese individuals, type 2 diabetics and those on long-term vitamin A derived supplementation are at a higher risk.
Clinical presentation
The most commonly affected location is the upper back, followed by the neck and lower back. Less commonly other joints such the shoulders, elbows, knees, heels etc. are involved.
The patient may be asymptomatic. When symptoms are present, they include pain and stiffness in the affected part. The normal range of motion may be compromised, thus making it difficult to make full use of the affected body part. When DISH affects the spine, it makes the bones more prone to fractures; even with minor trauma.
Severe DISH can lead to formation of bone spurs, thus giving rise to other symptoms due to compression.
Investigations
First a physical examination of the affected joint will be carried out. The patient is asked to undergo imaging tests X-rays, MRI or CT scans to confirm the diagnosis.
Treatment
Diffuse idiopathic skeletal hyperostosis is an incurable condition. Treatment is aimed at providing symptomatic relief and preventing complications.
The patient is advised to use heating pads for pain relief. He must exercise regularly in order to keep his joints mobile.
Pain relief can be achieved by oral pain-relieving medications or corticosteroid injections.
Physical therapy is recommended in order to maintain adequate mobility of the affected joints.
Any underlying associated conditions such as obesity or diabetes must be treated.
When bone spurs are present, surgical intervention may be needed.
