Among individuals with skeletal fluorosis, the fluoride-induced changes to the spine, and the accompanying symptoms, can bear a close resemblance to DISH and/or spondylosis.

Some authors have reported that distinguishing between certain cases of skeletal fluorosis and DISH is only possible via intrusive bone biopsy.

Excerpts from the Scientific Literature: Fluoride & DISH:

"Distinguishing between fluorosis and DISH may be difficult in fragmentary and less severe cases."
SOURCE: Littleton J. (1999). Paleopathology of skeletal fluorosis. American Journal of Physical Anthropology 109: 465-483.

"Our study shows that hyperostosis of the spine and peripheral skeletal parts occurs more frequently among fluoride-exposed aluminum smelter workers. It is similar to diffuse idiopathic skeletal hyperostosis. Separation of the fluoride-caused form from that etiologically unexplained idiopathic is only possible through bone biopsy."
SOURCE: Runge H, Franke J. (1989). Radiological modifications of the skeletal system among aluminum smelter workers: A 15 year retrospective study. Fluoride 22: 157-164.

"Hyperostosis as seen in fluorosis cannot be differentiated from Forestier's syndrome which may also have extraspinal manifestations."
SOURCE: Boillat MA, et al. (1980). Radiological criteria of industrial fluorosis. Skeletal Radiology 5: 161-165.

"In the aluminum workers, the most frequent changes in the spine were exostoses and ossification of the ligaments. These changes did not differ in appearance from those seen in spondylarthritis or vertebral ankylosing hyperostosis."
SOURCE: Czerwinski E, Lankosz W. (1978). Skeletal changes in industrial and endemic fluorosis. Fluoride 11:29-32.

General Info: Diffuse Idiopathic Skeletal Hyperostosis (DISH): (back to top)

"Diffuse idiopathic skeletal hyperostosis (DISH) has also been called Forestier's disease. It is considered a form of degenerative arthritis. DISH is characterised by flowing calcification along the sides of the vertebrae of the spine. It is also commonly associated with inflammation (tendinitis) and calcification of tendons at their attachments points to bone. This can lead to the formation of bone spurs, such as heel spurs. In fact, heel spurs are common among individuals with DISH."
SOURCE: MedicineNet.com

"Diffuse idiopathic skeletal hyperostosis (DISH) is a degenerative disorder of unknown etiology that frequently occurs in patients over 60. The distinguishing characteristic of this disorder is the presence of excessive ligamentous calcification and ossification of ligaments in the spine and extraspinal locations."
SOURCE: Consumer Health Information Network

General Info: Symptoms of DISH:

"Symptoms of DISH include intermittent pains in the areas of the bony changes of the spine and inflamed tendons. Stiffness and dull pain, particularly in the upper and lower back, are common. Sometimes pains in these areas can be sharp with certain body movements, such as twisting or bending over. DISH is only slowly progressive. Calcifications between the vertebrae occur over many years. This calcification can lead to limitation of motion of the involved areas of the spine."
SOURCE: MedicineNet.com

“Most patients present with stiffness of the back, although nonspecific back pain may be associated with DISH. Rarely, kyphosis is present. Dysphagia occasionally is attributed to prominent osteophytes in the cervical spine.”
SOURCE: eMedicine.com

“Neurologic manifestations (secondary to spinal canal stenosis), heterotopic ossification... can be seen.”
SOURCE: eMedicine.com

General Info: Frequency of DISH:

“In the US: Incidence generally is believed to be from 6-12%; however, the incidence probably is higher and is 28% in men older than 80 years”.
SOURCE: eMedicine.com

“In the US: DISH is present in approximately 19% of men older than 50 years and only 4% of women older than 50 years. Frequency information in the US was derived from the study of nonselected skeletal/cemetery populations.”
SOURCE: eMedicine.com

"Age: DISH usually occurs in persons aged 50-75 years."
SOURCE: eMedicine.com

General Info: Similarities between DISH & Senile Ankylosing Spondylitis:

"Clinically, DISH is often referred to as senile ankylosing spondylitis because of similarities in appearance between these two conditions, despite the differing ages of onset.”
SOURCE: eMedicine.com

General Info: Synonyms for DISH:

Forestier's Disease; spondylitis deformans; spondylosis hyperostotica Forestier; vertebral ankylosing hyperostosis.