DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS

Course overview

DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS (DISH) IS A SYSTEMIC CONDITION CHARACTERIZED BY CHARACTERISTIC OSSIFICATION PATTERNS THAT CAN OCCUR IN THE SPINE AND PERIPHERAL ENTHESES. DISH MOST COMMONLY AFFECTS THE SPINE AND OFTEN PRESENTS AS BACK PAIN AND STIFFNESS. RESNICK ET AL. ORIGINALLY COINED THE TERM DISH IN 1975 AND IS NOW THE MOST COMMONLY USED TERM TO DESCRIBE THIS CONDITION IN THE LITERATURE. THE TERM IS BOTH INCLUSIVE AND DESCRIPTIVE OF THE DISORDER. THE OSSIFICATIONS ARE CLASSICALLY DESCRIBED AS IN THE SPINE AS FLOWING OSSIFICATIONS ALONG THE ANTEROLATERAL ASPECT IN AT LEAST THREE SUCCESSIVE VERTEBRAL LEVELS, OR FOUR CONTIGUOUS VERTEBRAE. ALTHOUGH LESS COMMON, PERIPHERAL ENTHESOPATHY CAN OCCUR AT THE SHOULDER, ELBOW, KNEE, OR CALCANEUS. DISH IN THE SPINE MOST COMMONLY OCCURS ON THE RIGHT SIDE OF THE THORACIC SPINAL SEGMENT. THIS ACTIVITY REVIEWS THE ETIOLOGY, PRESENTATION, EVALUATION, AND MANAGEMENT OF DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS AND REVIEWS THE ROLE OF THE INTERPROFESSIONAL TEAM IN EVALUATING, DIAGNOSING, AND MANAGING THE CONDITION.