Pain and Functional Limitation of the Spine and Root Joints in Diffuse Idiopathic Skeletal Hyperostosis (DISH)

Overview

Diffuse idiopathic skeletal hyperostosis (DISH) is not a well known cause of pain and functionallimitation of the spine and root joints in middle and old age. The symptomatology is similar toankylosing spondylitis and both diseases are in clinical practice often confused. The main aim ofthe study was to evaluate the subjective symptoms and functional findings in patients with thediagnosis of DISH. A group of 65 patients with DISH confirmed by X-ray was examined as tocharacter, localisation, intensity and a frequency of pain and joint movement limitation. The mostcommon symptom was back pain found in 64 (98.46 %) patients and low back pain in 59 (90.77 %)patients, the average age at the beginning of back pain was 40 years. Limitation of movement of thecervical spine (rotation, inclination) was found in 12.5 %, pain during functional examination of thecervical spine in 42.2 %, limited movement of the lumbar spine in 35 %. The most frequent joint painwas found in the knee and the hip joint. The limitation of joint movement was most frequently foundduring inner rotation of the shoulder. 45 (69.23 %) patients described pain as a rare symptom in thepast, 25 (41.5 %) patients as a frequent symptom and 27 (41.5 %) patients described permanent painat present.

Key words:
diffuse idiopathic skeletal hyperostosis, pain, ankylosing spondylitis