Diffuse idiopathic skeletal hyperostosis (DISH): incidental radiologic finding in an older adult

Diffuse idiopathic skeletal hyperostosis (DISH) is a somewhat uncommon osteopathic disorder associated with interconnected ossifications along the anterior vertebrae and may be accompanied by systemic comorbidities. To date, there is limited information concerning DISH in the dental literature. The objective of this report was to provide an overview of DISH for the general dental practitioner, illustrated with a case report involving an asymptomatic patient. An 87-year-old man underwent a preprosthodontic assessment, including a CBCT scan. Incidental CBCT findings included bridging ossification involving the anterior aspects of C3 and C4, resulting in mild airway displacement and mild reduction in airway volume, left calcified carotid atheroma, and bilateral intracranial carotid artery calcifications. At a 5-month follow-up telephone call, the patient admitted that he had remained asymptomatic and has not experienced dyspnea, dysphagia, throat pain, or episodic choking. Dental health care clinicians should remain vigilant for the radiologic evidence of DISH, especially involving older patients. Patients with suspected cases of DISH warrant timely referral for a comprehensive medical evaluation.