Diffuse Idiopathic Skeletal Hyperostosis (DISH or Forestier's Disease)

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Catherine Burt Driver, MD
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

Symptoms of Rheumatoid Arthritis

Diffuse Idiopathic Skeletal Hyperostosis (DISH) Symptoms

I have just been diagnosed with diffuse idiopathic skeletal hyperostosis (DISH). I'm currently taking antiinflammatory medications. Are there any exercises and/or nutritional suggestions that will also help?

Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Melissa Conrad Stöppler, MD

You must consult your doctor for the proper advice for your particular situation. Because DISH can cause loss of range of motion of the spine, exercises that involve stretching the spinal range of motion can often be beneficial. Physical therapists are specifically trained to provide instructions in this area.

Diffuse idiopathic skeletal hyperostosis (DISH) facts

  • DISH is characterized by unique, flowing calcification along the sides of the contiguous vertebrae of the spine.
  • Symptoms of DISH include intermittent pains and stiffness in the areas of the bony changes of the spine and inflamed tendons.
  • DISH is diagnosed when the characteristic flowing calcifications are detected with images of the spine, such as in plain film X-ray methods.
  • Nonsteroidal anti-inflammatory medications (NSAIDs) can be helpful in both relieving pain and inflammation of DISH.

What is diffuse idiopathic skeletal hyperostosis?

Diffuse idiopathic skeletal hyperostosis (DISH) is considered a form of degenerative arthritis or osteoarthritis. However, DISH is characterized by unique, flowing calcification along the sides of the contiguous vertebrae of the spine. And, very unlike typical degenerative arthritis, it's also commonly associated with inflammation (tendinitis) and calcification of tendons at their attachments points to bone. This can lead to the formation of bone spurs, such as heel spurs. In fact, heel spurs are common among individuals with DISH. DISH has also been called Forestier's disease.

What causes diffuse idiopathic skeletal hyperostosis?

It is not known what causes DISH. DISH is associated with the metabolic syndrome and is more frequent in people with diabetes mellitus.

Medically Reviewed by a Doctor on 11/6/2015

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