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Diffuse Idiopathic Skeletal Hyperostosis with Hypoparathyroidism and Basal Ganglia Calcification: A Rare Clinical Entity

Tayyibah Shah Alam*

A systemic, musculoskeletal, non-inflammatory disorder, Diffuse Idiopathic Skeletal Hyperostosis (DISH), is characterized by ossification of various ligaments and enthuses. Most commonly it is prevalent in the elderly population, who are over the age of 50 years. Recent hypotheses suggest ossification of the anterior longitudinal ligament to be the most common site however, the pathophysiological mechanism is unclear. In this article, we discuss the case of a 58 years old gentleman who presented with restricted movements associated with pain in the neck and left shoulder and the comorbid condition of hypoparathyroidism with basal ganglia calcification. With a detailed clinical examination, investigations and inter disciplinary approach, a diagnosis of DISH was made. DISH, also referred to as forester’s disease, is a rare entity that mainly manifests as back pain along with stiffness, resulting in gradual loss of motion. One of the presentations can be dysphagia due to large osteophytes leading to mechanical obstruction. Inter disciplinary treatment approach and surgical excision of osteophytes in these cases lead to excellent results.