About vertebral ankylosing hyperostosis

What is vertebral ankylosing hyperostosis?

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier's disease, affects the ligaments around the spine. Sections of the ligaments turn into bone in this disorder, which is considered to be a form of degenerative arthritis.

The conversion of ligamental tissue to bone usually extends along the sides of the vertebrae of the spine. (This may be called flowing calcification.) Also, DISH is associated with inflammation (tendinitis) and calcification of the tendons, especially at the points at which the tendon attaches to the bones. When this happens, the patient is said to have developed bone spurs, especially in the heel and ankles (heel spurs).

DISH affects three or more vertebrae that are most often located in the chest or in the spine between the chest and pelvis. It is a disorder of older patients, more often affecting men than women ages 50-60. The disorder is often found in association with diabetes, high blood pressure, heart disease and obesity.

What are the symptoms for vertebral ankylosing hyperostosis?

Loss of range of motion symptom was found in the vertebral ankylosing hyperostosis condition

Patients may be asymptomatic or present mild to moderate back pain, abnormal pelvis bone morphology, abnormality of the vertebral column, osteoarthritis, obesity, and palmoplantar keratoderma.

What are the causes for vertebral ankylosing hyperostosis?

An autosomal dominant inheritance pattern

Autosomal means the gene is located on any chromosome except the X or Y chromosomes (sex chromosomes). Genes, like chromosomes, usually come in pairs. Dominant means that only one copy of the responsible gene (causal gene) must have a disease-causing change (pathogenic variant) in order for a person to have the disease. Mutation is an older term that is still sometimes used to mean pathogenic variant.

In some cases, a person inherits the pathogenic variant from a parent who has the genetic disease. In other cases, the disease occurs because of a new pathogenic variant (de novo) in the causal gene and there is no family history of the disease.

Each child of an individual with an autosomal dominant disease has a 50% (1 in 2) chance of inheriting the variant and the disease. Typically, children who inherit a dominant variant will have the disease, but they may be more or less severely impacted than their parent. Sometimes a person may have a pathogenic variant for an autosomal dominant disease and show no signs or symptoms of the disease

What are the treatments for vertebral ankylosing hyperostosis?

A spinal ankylosis caused by ligamentous ossification without major disc disease or facet joint involvement is referred to as ankylosing hyperostosis of the spine (AHS), also known as Forestier's disease or Vertebral Ankylosing Hyperostosis.

Treatments for Vertebral Ankylosing Hyperostosis

  • Vertebral Ankylosing Hyperostosis is incurable; however, there are things you can do to lessen discomfort and stiffness.
  • The goal of treatment is to stop complications and the condition from worsening.
  • Because of the link between DISH and diseases including type 2 diabetes, obesity, and insulin resistance, treating those diseases may be able to reduce or stop the growth of DISH.


  • Your physician might advise over-the-counter analgesics like acetaminophen (Tylenol, among others) or ibuprofen (Advil, Motrin IB, others).
  • Corticosteroid injections can be used to relieve pain that is more severe.


  • The stiffness linked to Vertebral Ankylosing Hyperostosis can be loosened up with physical treatment.
  • Your joint's range of motion may improve with exercise.
  • Ask your doctor what workouts you should do specifically.
  • He or she could suggest that you get additional assistance from a physical therapist.


  • In rare instances where diffuse idiopathic skeletal hyperostosis results in serious consequences, surgery may be required.
  • Surgery may be required to remove massive bone spurs in the neck that are causing people to have trouble swallowing.
  • Additionally, surgery may be able to relieve Vertebral Ankylosing Hyperostosis-related strain on the spinal cord.

Stiffness,Pain,Loss of range of motion,Difficulty swallowing or a hoarse voice
Disability,Difficulty swallowing,Spinal fracture
Acetaminophen (Tylenol, among others),Ibuprofen (Advil, Motrin IB, others),Corticosteroid injections

What are the risk factors for vertebral ankylosing hyperostosis?

Soft tissues, primarily ligaments, joint capsules, and the insertions of muscles and tendons, thicken, calcify, and ossify is Vertebral Ankylosing Hyperostosis.

  • The development of massive, flowing osteophytes as a result of aberrant bone growth is another characteristic of the illness.
  • Most of these ossifications are found in the axial skeleton, which is primarily found in the thoracic area.
  • Peripheral entheses such as the shoulders, olecranon, and metacarpophalangeal joints, as well as the peripatellar ligaments, Achilles tendon insertion, and plantar fascia, may also be impacted.

Risk factors for the Vertebral Ankylosing Hyperostosis

  • The severity of Vertebral Ankylosing Hyperostosis rises with age and is most prevalent in people who are elderly (50 years old).
  • In a group of people aged 50 and older, men are affected more frequently than women (15%), according to US prevalence statistics.
  • Although the exact cause of the disease is unknown, investigations have previously demonstrated that the clinical symptoms are connected to the growth of new bone.
  • It is believed that a number of metabolic variables influence the disease's development.
  • Vertebral Ankylosing Hyperostosis is more prevalent in:
  • Your risk can be raised by long-term use of retinoids, such as isotretinoin (Amnesteem, Claravis, among other brands), which is used to treat skin disorders like acne.

Risk factors for Vertebral Ankylosing Hyperostosis related to different metabolic disorders like,

  • Waist circumference
  • BMI / Obesity
  • Hyperinsulinemia
  • Diabetes mellitus
  • Hyperuricemia
  • Dyslipidemia
  • Hypertension
  • Coronary artery disease
  • Gout

Stiffness,Pain,Loss of range of motion,Difficulty swallowing or a hoarse voice
Disability,Difficulty swallowing,Spinal fracture
Acetaminophen (Tylenol, among others),Ibuprofen (Advil, Motrin IB, others),Corticosteroid injections

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