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Objectives: To estimate the prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in a cross-sectional study of elderly men age 65 to 100 years and to examine back and neck pain as possible correlates of DISH., Methods: DISH was defined using Resnick's criteria and scored according to Mata on lateral spine radiographs of 298 randomly selected participants from the MrOS Study. Standardized self-reported questionnaires were used to assess the frequency and severity of back and neck pain, and the relation of these to DISH status was estimated with χ(2) tests, as well as prevalence ratios and 95% confidence intervals using log-binomial regression models., Results: DISH was observed in 126 older men (42%), increased with age (30%, 39%, 48%, and 56% for ages 65-69, 70-74, 75-79, and ≥80 respectively), and was positively associated with body mass index (BMI) (P = 0.04) and blood pressure (P = 0.02). Significantly less back pain in the past 12 months was reported among men with DISH as compared to men without (59% vs 71%, P = 0.03), which remained after adjustment for age, BMI, and blood pressure (prevalence ratios = 0.73, 95% confidence interval = 0.57-0.95). Back pain severity (P = 0.07) and frequency (P = 0.06) were also less frequent among men with DISH compared to men without, whereas reported neck pain was similar between groups (P = 0.39)., Conclusions: Among community-dwelling elderly men, DISH prevalence is high, increases with age, and is positively associated with BMI and blood pressure. Frequency of self-reported back pain over the past 12 months was lower in older men with DISH as compared to those without DISH., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Background Context: Degenerative spondylolisthesis is a presumed cause of back pain. Previous studies of spondylolisthesis and back pain included only women or combined results for men and women. Comparisons of the frequency of back pain, neurogenic symptoms, and functional limitations specifically among elderly men with and without spondylolisthesis are needed., Purpose: To determine associations of prevalent spondylolisthesis with back pain symptoms, neurogenic symptoms, and functional limitations among elderly men., Study Design/setting: Cross-sectional epidemiologic study conducted within the Osteoporotic Fractures in Men (MrOS) cohort. The MrOS cohort is composed of 5,995 community-dwelling men aged 65 years or older who were recruited at six US academic medical centers. Extensive self-reported data and lumbar spine radiographs were obtained for all MrOS participants at baseline., Patient Sample: For this study, 300 men were selected at random specifically for the evaluation of spondylolisthesis on the baseline spine radiographs., Outcome Measures: Standardized questionnaires were used to assess self-reported back pain, leg pain (radiculopathy), lower extremity numbness (paresthesias), and lower extremity weakness occurring in the past 12 months and to ascertain current difficulty with activities of daily living., Methods: In the present study, radiographic spondylolisthesis was classified as forward slip of ≥5%. Prevalence of back pain, neurogenic symptoms, and difficulty with activities of daily living was compared between men with and without spondylolisthesis using chi-square or Fisher exact tests., Results: Spondylolisthesis was present among 92 (31%) men. Among men with and without spondylolisthesis, back pain (63% vs. 67%, p=.46) and moderate/severe back pain (41% vs. 38%, p=.76) were reported with similar frequency. Men with spondylolisthesis more often reported radiculopathy (33% vs. 22%, p=.06), paresthesias (18% vs. 11%, p=.10), and weakness (18% vs. 9%, p=.02) in the lower extremities, as well as difficulty walking two to three blocks (21% vs. 11%, p=.03), doing their own shopping (8% vs. 2%, p=.04), and getting in/out of a car (14% vs. 6%, p=.03), compared with men without spondylolisthesis., Conclusions: Among elderly men, spondylolisthesis was associated with neurogenic symptoms and lower extremity functional limitations; however, spondylolisthesis was not associated with a higher likelihood of back pain in this population., (Copyright © 2010 Elsevier Inc. All rights reserved.)

This case study reports on complaints of midthoracic back pain and dysphagia in a patient with significant osteophytes in the context of Diffuse Idiopathic Skeletal Hyperostosis (DISH). The clinical and radiologic phenomena of DISH are discussed. Despite the presence of important structural radiologic abnormalities in the thoracic spine in our patient, there was a good clinical recovery after exercise and manual therapy aimed at improvement of posture, functional scapulothoracic stability, strength of the interscapular muscles, length of the pectoral muscles, and mobility of the cervicothoracic and upper thoracic spine. We suggest that functional factors rather than structural abnormalities played a causal role in the genesis of midthoracic back pain in our patient. [ABSTRACT FROM AUTHOR]