Two Cases Report of Dysphagia Due to Diffuse Idiopathic Skeletal Hyperostosis (DISH)
Diffuse idiopathic skeletal hyperostosis is an ossifying disorder
characterized by spinal and peripheral neuropathy.
Forestier and Rotes Querol were the first two who discovered this disease and
presented it as senile ankylosing hyperostosis of the spine by the
name of Forestier Disease in 1950.
They described it as an idiopathic disorder causing ossification
in the anterior cervical spinal ligaments with its progression
and eventual encroachment on adjacent structures.
Since then many different terms other than Forestier Disease
were used to describe this condition. These included
ankylosing spondylosis, spondylosis deformans and
Later in 1975 this pathology was designated by Resnick
et al as Diffuse Idiopathic Skeletal Hyperostosis or DISH.
They proposed the Resnick criteria as a flowing ossification
at the anterolateral aspect of four contiguous vertebral bodies,
a preserved disc height, and an absence of the degeneration
or sclerosis of the corresponding apophyseal joint.
Today, DISH is used for the more generalized form
of the disease involving axial and extra-spinal ligaments.
Based on radiological surveys of the cervical spine 2.4-
5.4% of individuals above 50 years of age have Forestier’s disease.
Reports have shown an increase of 28% of the DISH in the elderly.
The most common extra-spinal clinical manifestation of this disease
presents as dysphagia followed by respiratory disturbances such as,
dyspnea, sleep apnea, stridor and dysphonia.
Orthop Res Traumatol Open J. 2018; 3(1): 26-32. doi: 10.17140/ORTOJ-3-113