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Diffuse Idiopathic Skeletal Hyperostosis (DISH), Cervical Spine

ICD-10 Code
M48.12

Calcification and ossification of ligaments along the cervical spine, leading to stiffness.

Clinical Presentation & Protocol

Patient Usually Complains Of

Patient presents with progressive cervical stiffness and restricted range of motion. Reports chronic, dull neck pain, occasional dysphagia, and sensation of "fullness" in the throat. Denies radicular symptoms, myelopathic signs, or recent trauma. Symptoms are insidious in onset and slowly progressive.

Clinical Examination Findings

Cervical spine examination reveals significant limitation in flexion, extension, and lateral rotation. Palpation demonstrates diffuse paraspinal muscle tenderness without focal trigger points. Neurological exam is intact: motor strength 5/5 in all upper extremities, reflexes 2+ and symmetric, no pathological reflexes (negative Hoffmanโ€™s, negative Babinski). No midline tenderness over spinous processes.

Treatment Protocol

Conservative management initiated: prescription of NSAIDs for inflammation, physical therapy focusing on gentle cervical mobilization and postural correction. Advised weight management and metabolic screening (glucose/insulin levels). Follow-up imaging (lateral cervical X-ray) to monitor progression of anterior longitudinal ligament ossification.

Detailed clinical guide coming soon.