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Diffuse idiopathic skeletal hyperostosis (DISH): where we are now and where to go next
  1. Reuven Mader1,2,
  2. Jorrit-Jan Verlaan3,
  3. Iris Eshed4,
  4. Bruges-Armas Jacome5,6,
  5. Piercarlo Sarzi Puttini7,
  6. Fabiola Atzeni7,
  7. Dan Buskila8,
  8. Eyal Reinshtein9,
  9. Irina Novofastovski1,
  10. Abdallah Fawaz1,
  11. de Vlam Kurt10 and
  12. Xenofon Baraliakos11
  1. 1 Rheumatic Diseases Unit, Ha'Emek Medical Center, Afula, Israel
  2. 2 Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
  3. 3 Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
  4. 4 Department of Radiology, Musculoskeletal Imaging Unit, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
  5. 5 Medicine, Rheumatology, SEEBMO, Hospital de Santo Espirito da ilha Terceira, Universidade do Porto, Angra do Heroísmo, Portugal
  6. 6 CEDOC, Nova Medical School, University of Lisbon, Lisbon, Portugal
  7. 7 Rheumatology Unit, L. Sacco University Hospital of Milan, Milan, Italy
  8. 8 Department of Medicine, H. Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel
  9. 9 Department of Genetics, Meir Medical Center, Kfar Saba, Israel
  10. 10 Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium
  11. 11 Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany
  1. Correspondence to Dr Reuven Mader; rmader{at}, Mader_r{at}


Diffuse idiopathic skeletal hyperostosis (DISH) is a well-recognised entity characterised by calcifications and ossifications of the entheses affecting mainly the spine and peripheral sites. DISH is still insufficiently investigated and understood. The objective of this report is to highlight the present limitations of our understanding of the condition and suggest future research paths.

  • Low Back Pain
  • Osteoarthritis
  • Tendinitis
  • Spondyloarthritis

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  • Contributors All authors contributed equally to the content of the paper.

  • Funding The study group was supported by an unconditional grant from Pfeizer Israel and Abbvie Israel.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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