Diffuse Idiopathic Skeletal Hyperostosis or DISH is a disease of the ligaments of the spine.  The ligaments that support the spine become ossified and turn to bone.  DISH occurs in 19% of men and 4% of women over 50 years old.  This syndrome is asymptomatic.  Occasionally, swallowing problems may occur due to nerve injury.  There mild be some mild discomfort in the back area.  Occasionally, compression of the spinal chord can occur, leading to nerve damage.  When this occurs, symptoms related to the bowels or bladder may appear.  The diagnosis of Diffuse Idiopathic Skeletal Hyperostosis is made by X-Rays.  When the bony overgrowth spans three vertebral segments, the diagnosis is made.  MRI scans may allow better visualization of the spine and nerve roots, looking for compression.  The pain of DISH syndrome can mimic may other diseases such as bursitis, arthritis, and radiculopathy.  Treatment is conservative and includes physical therapy and non-steroidal anti-inflammatory medications.  If compression of the nerve roots is an issue, an epidural nerve block may be useful as well.