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2.4.3 Treatment
Pain control with acetaminophen and NSAIDs is the mainstay of treatment.
Physical therapy and exercise may relieve some symptoms and improve function.
Surgery is needed if compression is present and causing symptoms.
2.4.4 Imaging
The current accepted diagnostic criteria for DISH is based on plain radiography of
the thoracic spine [
36
]. Large,
cation over the thoracic
spine is typical, extending over at least four vertebral bodies (Fig.
7
). Preservation
of intervertebral disk heights and absence of facet
fl
flowing right-sided ossi
joint and sacroiliac joint
involvement are also required for diagnosis.
Fig. 7 Plain radiograph of
the thoracic spine in a patient
with diffuse idiopathic
skeletal hyperostosis.
Anteroposterior view of a
thoracic spine. Radiolucent
areas (arrow) indicate space
between ossi
ed longitudinal
ligament and the vertebral
bodies. The changes are
predominantly located on the
right side of the thoracic spine
