Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Anyone familiar with DISH?

I was initially told by my general doctor, and by my rheumatologist, months ago that I more than likely had AS. However, after my appointment yesterday, my rheumatologist team now believes I have something called DISH (Diffuse Idiopathic Skeletal Hyperostosis).

The two conditions are very similar, but DISH is not classified as an autoimmune disorder. He wanted to be confident in his diagnosis before prescribing me Humira. He noted that even though I'm positive for the gene that's common in AS sufferers, the last 3 blood tests I've had over 9 months have all shown my 'inflammation markers' as being well below average even for a 'normal' person. He also said that my age (55) and lack of any previous eye or kidney issues made him believe DISH was a more probable condition.

He suggested that I come back in another 9 months for another set of x-rays which his team can compare and draw a final conclusion between AS or DISH. There are evidently some specific characteristics that show on the images that make the differentiation easier.

I have to say that I was very impressed with their work and appreciate them not making the easier assumption of AS and putting me on meds that wouldn't have had any affect on DISH and could have potentially caused other problems. I'll check back in with the final results in 9 months and we'll see what happens. I'm not saying DISH is any better than AS because he pointed out that at least there's a treatment for AS, there's nothing for DISH except NSAID's.

Yes, I have had that diagnosis after the Rheumatologist saw X-rays of my rib cage.

After years of NSAID'S I have ringing in my ears it is very distracting.

My marker's are often blow normal also. I have heard the term lack of Iritis or lack of Kidney problems also conclude such determinations.

I have some fusion, but not classic.

diet, exercise, self control and lots of study are called ofr these days.

Keep us posted

Another way to distinguish between the two:

autoimmune / autoinflammatory diseases often come with:

flares
fatigue
overall achiness
stiffness all over especially upon waking or inactivity
rashes such as malaria rash and/or erythema nodosum

spondyloarthropathies in general can often include:

psoriasis (even minor - a dermatologist can dx)
GI inflammation (gastritis and inflammation of the ileum seen on a colonoscopy)
enthesitis (mine was very bad in the wrists and feet along with the neck and SI)
sacroiliitis (especially if it flares - mine flared so dramatically it couldn't be anything else)

So, my spondyloarthropathy wasn't dx'ed from my spinal films, but rather by putting all those other symptoms together to form a whole picture.

And then some good detective work by some good doctors.

Hi msmart - DISH. Interesting disease. Needs an MRI, sagittal STIR Coronal, fat supression, T1, T2. of the spine. The spine in DISH looks like the edges of a dripping candle. Quite a bit of info on the internet. Most unusual to have with AS - from memory...five cases in all are confirmed, dual AS & DISH.

Suggest a second opinion - Cleveland Clinic ? Or minimum, an MRI.

Molly- I am one that has been diagnosed with both, and other things as well.

thanks for your continued to info! love ya.

Yes. Knew that Lon - darn wretched. Is special, but heck, better ways to have it proven...

'A' rheumy in Paris was bent on my being DISH - Not. Had it all re-checked, heck, not even a side dish...!

Take care Lon - waiting for another saga from you, but, no hurting yourself, OK ? <LOL>

Big (((HUGS)))