Forestier's disease
| Classification according to ICD-10 | |
|---|---|
| M48.1 | Hyperostotic spondylitis (Forestier-Ott) Diffuse idiopathic skeletal hyperostosis (DISH) |
| ICD-10 online (WHO version 2019) | |
Forestier's disease is a systemic, non-inflammatory skeletal disease named after the French internist Jacques Forestier (1890–1978) , which is also called hyperostatic spondylosis and the icing spine . Ossification of the entheses is characteristic, i.e. those points on the bone where a tendon , ligament or joint capsule attach. Forestier and his pupil Jaume Red-Querol described the disease in 1950 as "senile stiffening hyperostosis of the spine " (English. Senile ankylosing hyperostosis of the spine ). Bony additions to the vertebral bodies have been observed primarily in older patients, which increase more and more over time and lead to a bridging of the intervertebral disc spaces over time. Since Forestier's disease affects large sections of the spine, it is accompanied by an increasing stiffening of the spine. It is now known that the disease is not restricted to the spine or to the elderly. In 1976 Donald R. Resnick and Gen Niwayama coined the term Diffuse Idiopathic Skeletal Hyperostosis ( DISH for short ), which is currently widespread. They pointed out that the disease was described by the radiologist Albert Oppenheimer as early as 1942.
causes
The causes are still unclear. Mechanical and genetic factors, exposure of the body to fluorides , vitamin A ( retinol ) and therapeutically used retinoids such as isotretinoin , etretinate and acitretin as well as certain metabolic conditions are suspected to be of underlying relevance . The DISH is common in patients with diabetes (diabetes mellitus) and dyslipidemia observed. But it also occurs as an independent disease without any other underlying disease.
diagnosis
The diagnosis of DISH can be made on plain radiographs alone . The x-ray of the vertebral bodies shows a mostly right-hand sugar-icing coating of bone material (hyperostoses). By bridging the intervertebral disc spaces, the mobility of the spine is eliminated in this segment.
Differential diagnosis
Bony outgrowths ( osteophytes ) also occur when the spine is worn down ( osteochondrosis intervertebralis or spondylosis deformans ). In Forestier's disease, however, there are no marginal spikes and it not only affects worn-out sections of the spine.
therapy
So far there are no therapeutic approaches that aim to slow down the increasing calcifications. Treatment is symptomatic, i.e. H. with pain relievers for pain, anti-inflammatory drugs for superimposed inflammatory symptoms and with physical therapy (especially heat applications and massages for accompanying muscle tension) as well as with physiotherapy to avoid functional impairment or to restore function if functional deficits have already occurred.
Individual evidence
- ↑ Wolfgang Miehle: Joint and spinal rheumatism. Eular Verlag, Basel 1987, ISBN 3-7177-0133-9 , p. 175.
- ^ Jacques Forestier, Jaume Rotes-Querol: Senile ankylosing hyperostosis of the spine. In: Ann Rheum Dis. 1950 Dec; 9 (4): 321-30. PMID 14800245 , PMC 1011670 (free full text).
- ↑ a b Fábio A. Nascimento et al .: Diffuse idiopathic skeletal hyperostosis: A review. In: Surg Neurol Int. 2014 Apr 16; 5 (Suppl 3): S122-5. doi : 10.4103 / 2152-7806.130675 (currently unavailable) , PMID 24843807 , PMC 4023007 (free full text).
- ↑ Albert Oppenheimer Calcification and ossification of vertebral ligaments (spondylitis ossificans ligamentosa): Roentgen study of pathogenesis and clinical significance. In: Radiology. 1942; 38: 160-173. doi : 10.1148 / 38.2.160 .
- ↑ Donald R. Resnick et al .: Diffuse idiopathic skeletal hyperostosis (DISH) [ankylosing hyperostosis of Forestier and Rotes-Querol]. In: Semin Arthritis Rheum. 1978 Feb; 7 (3): 153-87. doi : 10.1016 / 0049-0172 (78) 90036-7 , PMID 341323 .
literature
- Carl Joachim Wirth: Practice of orthopedics. Georg Thieme Verlag, Stuttgart / New York 2001, ISBN 3-13-125683-4 .
