Definition:

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier disease, is a systemic noninflammatory disease characterized by ossification of the entheses. It affects mainly elderly men, and involves the ossification of the anterior longitudinal ligament (OALL). Although it is asymptomatic in some occasions, the disease may produce dysphagia, dysphonia, and exceptionally breathing difficulties due to airway compromise. In these cases, early surgery is recommended to alleviate airway obstruction. Although the hallmark of the DISH is considered to be the anterolateral aspect of the thoracic spine, various signs and symptoms are not limited to the spine and have often been reported to involve multiple peripheral locations as well. While the cause of DISH remains unclear, mechanical factors, genetic factors, environmental factors, drugs, and metabolic conditions have been hypothesized to be relevant. Most of the current theories focus on the pathologic OALL. There's no cure for DISH. Therapy for DISH is based on symptomatic and empiric treatment. In general, physical therapy, analgesics, antiinflammatory drugs, and muscle relaxants have been successful in managing the majority of patients with DISH.