A controlled study of diffuse idiopathic skeletal hyperostosis. Clinical features and functional status

Area of Science:

• Rheumatology
• Geriatric Medicine
• Orthopedics

Background:

• Diffuse idiopathic skeletal hyperostosis (DISH) is a prevalent yet underdiagnosed condition in older adults.
• Its prevalence is estimated at 3.8% in men and 2.6% in women over 40.
• DISH is often overlooked by medical professionals.

Purpose of the Study:

• To investigate the clinical characteristics and disability associated with DISH.
• To compare patients with DISH to those with lumbar spondylosis and healthy controls.
• To establish DISH as a distinct clinical entity.

Main Methods:

• A case-control study involving 130 participants: 56 with DISH, 43 with lumbar spondylosis, and 31 healthy controls.
• Evaluation included pain history, physical examination, and standardized disability indices.
• Laboratory tests were also performed for comparison.

Main Results:

• DISH patients reported more upper extremity pain, enthesitis, and dysphagia than spondylosis patients.
• Increased extremity and spinal stiffness and pain were noted in DISH patients compared to healthy controls.
• DISH patients exhibited greater limitations in neck, thoracic, and lumbar spine mobility and had higher BMIs.

Conclusions:

• DISH is a distinct disorder with specific symptoms and physical findings differentiating it from other spinal conditions.
• The condition is associated with significant pain, stiffness, reduced mobility, and potential for major disability.
• Further research is needed on DISH's natural history, pathogenesis, and treatment options.