Diffuse Idiopathic Skeletal Hyperostosis (DISH) Clinical Presentation

Updated: Aug 03, 2022
  • Author: Bruce M Rothschild, MD; Chief Editor: Jeffrey D Thomson, MD  more...
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Diffuse idiopathic skeletal hyperostosis (DISH) is often an asymptomatic phenomenon that is discovered incidentally on imaging studies taken for some other reason. Reported manifestations, which may result from neuropathy or from physical impingement by bony overgrowth, have included the following [1] :

  • Polyarticular pain
  • Neck/thoracic/lumbar/extremity pain
  • Acute monoarticular synovitis
  • Limited range of spinal motion
  • Dysphagia [39]
  • Increased susceptibility to unstable spinal fractures
  • Airway obstruction of varying degrees

Physical Examination

If vertebral fusion is quite extensive, reduction in range of spinal motion occurs. [40] Because uniform vertebral involvement is extremely rare, no relatable findings exist.