Forestier’s disease is a disease that is accompanied by pathological changes in the vertebral bodies. The disease occurs predominantly in older people and is often associated with metabolic diseases such as diabetes mellitus. The majority of those affected are male.
Origin
Forestier’s disease is also called “diffuse idiopathic skeletal hyperostosis”, which means “increased, distributed ossification of the spinal column for unknown reasons”. As the name suggests, the cause is definitely unknown. In every human being, the spine consists of vertebral bodies, i.e. bones that are flexibly connected to each other by small joints.
Between the bones are the intervertebral discs, which provide a certain amount of suspension and damping along the vertebrae. In Forestier’s disease, however, the front of the spinal column is increasingly ossified throughout, especially at the level of the thoracic and lumbar vertebrae. It is also called “sugar icing” because the spine looks as if it had been sugar iced from the front in the X-ray image. As a result of this ossification, the spinal column can only move at a reduced level and damping is reduced. Although no real cause of the disease is known, an above-average number of patients with metabolic disorders such as gout or diabetes mellitus also suffer from Forestier’s disease.
Symptoms
The symptoms experienced by patients with Forestier’s disease vary in severity, but pain usually occurs and can reach considerable levels. The pain usually occurs at the level of the affected vertebrae, but occasionally there is also irritation of the nerve roots exiting the spinal cord. This can then also lead to pain in the arms, legs and shoulder, much like a herniated disc. Some patients, on the other hand, have no pain at all and the disease is only recognized by chance. In addition, the ossification of the spinal column restricts movement.
Diagnostics
Since the symptoms of Forestier’s disease are anything but clear, further diagnostic measures must be taken if Forestier’s disease is suspected. On the one hand, a blood test can exclude other rheumatological diseases as the cause of the complaints. In addition, the spinal column should be x-rayed.
Here one can see the bony changes directly if Forestier’s disease is present. Other degenerative, but age-related changes in the vertebral bodies can also be seen in the X-ray image. These normal wear and tears can also cause considerable discomfort without Forestier’s disease being present.
In particular, a neurological examination should also be performed for complaints radiating into the arms or legs. This means that sensitivity and mobility as well as reflexes of the affected areas are examined. In order to rule out a herniated disc, which can cause similar complaints, it may be necessary to perform an MRI of the spine.