Forestier's sygdom

Synonymer

Diffuse idiopathic skeletal hyperostosis (DISH), Forestier's disease, ankylosing hyperostosis

Historisk

Jacques Forestier (1890–1978)

Beskrivelse

Non-inflammatorisk spondyloarthropathi. It is characterized by spiny ankylosis and ossification of spinal ligaments and entheses. Involvement is variable, but can involve the entire spine. The disc spaces and facet joints remain unaffected. Classically, advanced disease may have "melted candle wax" appearance along the spine on radiographic studies.

The calcification and ossification is most common on the right side of the spine. In people with dextrocardia and situs inversus this calcification occurs on the left side, which confirms the role of the descending thoracic aorta in preventing the physical manifestations of DISH on one side of the spine.

Symptomer

DISH may be symptomatic for thoracic spinal pain in approximately 80% of patients. It may also be discovered as an incidental radiological abnormality, as mentioned above, without any symptoms. Back pain or stiffness is worse in the morning in almost two-thirds of patients. Increased incidence of dysphagia is also reported in some cases.[6][7] Similar calcification and ossification may be seen at peripheral entheseal sites, including the shoulder, iliac crest, ischial tuberosity, trochanters of the hip, tibial tuberosities, patellae, and bones of the hands and/or feet.[8]

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