What is the cause of diffuse idiopathic skeletal hyperostosis

Diffuse idiopathic skeletal hyperostosis, also known as obligatory skeletal hyperostosis, is a disease that is particularly susceptible to middle-aged and elderly men. When suffering from the disease, it can cause symptoms such as stiffness in the neck, waist, back and peripheral joints, and pain in the limbs.

1. Causes

The cause of this disease is unknown. Although there have been reports of familial cases, they are rare. Research data suggest that the disease may be caused by mechanical factors acting on certain attachment points, but more and more data show that systemic growth and metabolic abnormalities are risk factors for this disease. In addition to the early report by Forestier that this disease is associated with obesity, the association between this disease and impaired glucose tolerance and adult-onset diabetes has recently been confirmed.

2. Clinical manifestations

The disease has an insidious and slow onset with mild symptoms. There is generally no special discomfort in the early stage of the disease. Mobility is limited after fatigue, cold or long-distance car ride, and there may even be stiffness in the neck, back and peripheral joints and pain in the limbs. When calcaneal, olecranon osteophytes or talar spurs appear, heel pain, elbow pain or foot pain may occur; sometimes tendon enditis occurs at the attachment of tendons, ligaments and bones, causing pain. A notable feature of this disease is that the clinical symptoms are milder than the X-ray manifestations.

Treatment

Asymptomatic DISH patients with only X-ray manifestations do not require drug treatment, but they must strengthen the protection of the spinal joints and perform appropriate activities. Those with obvious symptoms can be treated symptomatically, such as physical therapy or nonsteroidal anti-inflammatory drugs. For patients with symptoms of nerve compression or severe limitation of joint movement, removal of hypertrophic osteophytes or ossified ligaments may be considered.

1. Avoiding obesity plays a positive role in the prevention and treatment of this disease. Drugs that cause increased blood sugar and increase the risk of cardiovascular and cerebrovascular diseases, such as thiazides, beta-blockers, exogenous insulin, etc., should be avoided. Avoid heavy drinking.

2. The disease is mainly treated symptomatically and with complications. Non-steroidal drugs and other analgesics can be used to relieve pain and stiffness. The principles and usage are the same as those for the treatment of osteoarthritis. In addition, low-dose chemotherapy has a certain effect on patients with obvious local ligament ossification; local injection of corticosteroids can be used for patients with obvious pain in the peripheral attachment area and who are not effectively treated with non-steroidal drugs. If the new bone forms and blocks or compresses other tissues, causing serious complications such as spinal cord compression and spinal cord lesions, surgical treatment may be considered.