$Unique_ID{BRK03749} $Pretitle{} $Title{Forestier's Disease} $Subject{Forestier's Disease Diffuse Idiopathic Skeletal Hyperostosis DISH Vertebral Ankylosing Hyperostosis Spinal Diffuse Idiopathic Skeletal Hyperostosis Spinal DISH Osteoarthritis Spondylosis Ankylosing Spondylitis Rheumatoid Arthritis} $Volume{} $Log{} Copyright (C) 1991 National Organization for Rare Disorders, Inc. 826: Forestier's Disease ** IMPORTANT ** It is possible that the main title of the article (Forestier's Disease) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Diffuse Idiopathic Skeletal Hyperostosis DISH Vertebral Ankylosing Hyperostosis Spinal Diffuse Idiopathic Skeletal Hyperostosis Spinal DISH Information on the following disorders can be found in the Related Disorders section of this report: Osteoarthritis Spondylosis Ankylosing Spondylitis Rheumatoid Arthritis General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Forestier's Disease is one of the many forms of Osteoarthritis. Major symptoms may include areas of bony overgrowth or bone spurs which usually develop along the spine without breakdown of spinal discs. Symptoms In Forestier's Disease, areas of bony overgrowth or bone "spurs" develop, most often on a segment of the spine anywhere from below the neck to the lower back (thoracic and lumbar areas of the spine). Other sites may include areas where tendons join bones (tendon osseous junctions) such as at the heel of the foot. Occasionally Forestier's Disease affects the elbow. Some patients may feel pain in the affected area(s). Occasionally, bony overgrowths may place pressure on nearby nerves (nerve compression or entrapment) causing irritation. Uncommonly, Forestier's Disease affects the cervical (neck) area of the spine (cervical DISH). This may cause the patient to experience difficulty in swallowing (dysphagia) or speaking (dysphonia). This type of the disorder is often seen in people who have Diabetes Mellitus. (For more information choose "Diabetes Mellitus" as your search term in the Rare Disease Database). Causes The exact cause of Forestier's Disease is unknown. Changes in cartilage may cause the bony overgrowths to occur. This may be due to aging, trauma, or "wear and tear" such as from sports. Disorders which involve disturbances in cartilage metabolism such as diabetes mellitus or acromegaly, or certain inherited connective tissue disorders may also cause Forestier's Disease. (For more information choose "diabetes mellitus," "acromegaly," or "connective tissue" as your search terms in the Rare Disease Database). Affected Population Forestier's Disease is a common subtype of osteoarthritis. It generally affects men and women over the age of 50. Related Disorders Symptoms of the following disorders can be similar to those of Forestier's Disease. Comparisons may be useful for a differential diagnosis: Osteoarthritis is a very common degenerative joint disease characterized by loss of cartilage, deformities of bones and joints, and thickening of the surrounding ligaments and membranes at the joint margins with areas of bony outgrowths. Osteoarthritis develops when cartilage repair does not keep pace with cartilage degeneration. It may occur as a result of trauma to the bone, aging, obesity, or other underlying diseases which cause damage to the joint or its cartilage such as congenital dislocation of the hip or Rheumatoid Arthritis. Osteoarthritis is suspected to be an autoimmune disease. In these types of disorders the body's natural defenses against foreign substances (e.g. antibodies or lymphocytes) attack healthy tissue for unknown reasons. Spondylosis is osteoarthritis of the spine. It is characterized by a breakdown of the spinal discs in between the vertebrae; this does not occur in Forestier's Disease. (For more information on disorders involving osteoarthritis, choose "osteoarthritis" as your search term in the Rare Disease Database). Ankylosing Spondylitis is a chronic progressive form of arthritis primarily involving the spine and paraspinal structures. It is distinguished by inflammation and eventual immobility (ankylosis) of a number of spinal joints. Onset is usually gradual with episodes of low back pain, especially in the region of the tailbone and hips (sacroiliac), and the lower (lumbar) spine. Morning back stiffness often occurs. Symptoms commonly become progressively worse, spreading from the low back into the mid-back and occasionally the neck. (For more information on this disorder, choose "Ankylosing Spondylitis" as your search term in the Rare Disease Database). Rheumatoid Arthritis is also suspected of being an autoimmune disease. It is characterized by lack of appetite (anorexia), tiredness, painful and deformed joints, early morning stiffness chiefly in the hands, knees, feet, jaw, and spine. Once affected, a patient's joints remain painful or uncomfortable for weeks, months, or even years. (For more information choose "Rheumatoid Arthritis" as your search term in the Rare Disease Database). Therapies: Standard Testing for Forestier's Disease may include imaging techniques such as X- rays, computed tomographic (CT) scans, or the use of a lighted instrument with a flexible tube (endoscopy). Treatment may include anti-inflammatory non-steroid drugs. Sometimes surgery to correct deformities may be prescribed. Other treatment is symptomatic and supportive. Therapies: Investigational Scientists are pursuing substantial research on all forms of arthritis and other autoimmune diseases. It is hoped that better understanding of the immune system will lead to improved treatments and prevention of degenerative processes that cause pain and malformations that characterize arthritis. This disease entry is based upon medical information available through January 1991. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Forestier's Disease, please contact: National Organization for Rare Disorders P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 The National Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse Box AMS Bethesda, MD 20892 (301) 495-4484 Arthritis Foundation 1314 Spring Street Atlanta, GA 30309 (404) 872-7100 Ankylosing Spondylitis Association 511 North La Cienega, Suite 216 Los Angeles, CA 90048 (213) 652-0609 (800) 777-8189 Coaltion of Heritable Disorders of Connective Tissue c/o National Marfan Foundation 382 Main St. Port Washington, NY 11050 (516) 944-5412 References CECIL TEXTBOOK OF MEDICINE, 18th Ed.: James B. Wyngaarden, and Lloyd H. Smith, Jr., Editors; W.B. Saunders Co., 1988. Pp. 2039-2041. DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS CAUSING ACUTE THORACIC MYELOPATHY: A CASE REPORT AND DISCUSSION. A. Reisner, et al.; Neurosurgery (Mar 1990; issue 26 (3)). Pp. 507-511. DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS (DISH) OF THE SPINE: A CAUSE OF BACK PAIN? A CONTROLLED STUDY. P. Schlapbach, et al.; Br J Rheumatol (Aug 1989; issue 28 (4)). Pp. 299-303. DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS WITH DYSPHAGIA (A REVIEW). E. Eviatar and M. Harell; J Laryngol Otol (Jun 1987; issue 101 (6)). Pp. 627- 632. DYSPHAGIA DUE TO DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS. W. J. Shergy, et al.; Am Fam Physician (Apr 1989; issue 39 (4)). Pp. 149-152. DYSPHONIA CAUSED BY FORESTIER'S DISEASE. I. Gay and J. Elidan; Ann Otol Rhinol Laryngol (May-Jun 1988; issue 97 (3 Pt 1)). Pp. 275-276. RADIOGRAPHIC, CLINICAL, AND HISTOPATHOLOGIC EVALUATION WITH SURGICAL TREATMENT OF FORESTIER'S DISEASE. J. G. Barsamian, et al.; Oral Surg Oral Med Oral Pathol (Feb 1985; issue 59 (2)). Pp. 136-141.