{"id":2992,"date":"2024-11-20T23:49:55","date_gmt":"2024-11-20T23:49:55","guid":{"rendered":"https:\/\/kamranaghayev.com\/dish-hastaligi\/"},"modified":"2025-05-11T12:58:47","modified_gmt":"2025-05-11T12:58:47","slug":"dish-hastaligi","status":"publish","type":"post","link":"https:\/\/kamranaghayev.com\/tr\/dish-hastaligi\/","title":{"rendered":"Yayg\u0131n \u0130diopatik \u0130skelet Hiperostozu &#8211; DISH"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\" id=\"h-key-facts-on-dish-disease\">DISH Hastal\u0131\u011f\u0131 Hakk\u0131nda Temel Bilgiler<\/h2>\n\n<ul class=\"wp-block-list\">\n<li class=\"\">A\u00e7\u0131l\u0131m\u0131 Diff\u00fcz \u0130diopatik \u0130skelet Hiperostozu (di\u011fer ad\u0131yla Forestier hastal\u0131\u011f\u0131) olan DISH, iskelet sistemini etkileyen ve entezis b\u00f6lgelerinde ekstra kemik (osteofit) olu\u015fumu ile karakterize sistemik bir hastal\u0131kt\u0131r. T\u0131p literat\u00fcr\u00fcnde entezis, ba\u011f dokusunun (ligament, tendon, eklem kaps\u00fcl\u00fc vb.) kemi\u011fe ba\u011fland\u0131\u011f\u0131 anatomik b\u00f6lgeyi ifade eder. Bu nedenle DISH entezopatidir.<\/li>\n\n\n\n<li class=\"\">DISH \u00f6ncelikle omurgay\u0131 etkiler ve anterior longitudinal ligament boyunca osteofit olu\u015fumu ile kendini g\u00f6sterir. \u00c7o\u011funlukla omurga etkilense de, pelvis ve ekstremitelerde ekstra spinal belirtiler nadir de\u011fildir. \u0130lgin\u00e7 bir \u015fekilde, DISH&#8217;de sakro-iliak eklemler etkilenmez.<\/li>\n\n\n\n<li class=\"\">DISH&#8217;in kesin nedeni bilinmemektedir, ancak genetik, metabolik, enflamatuar ve davran\u0131\u015fsal fakt\u00f6rlerin kombinasyonunun hastal\u0131\u011fa neden olmas\u0131 muhtemeldir. DISH, ankilozan spondilit ve osteoartrit gibi di\u011fer iskelet hastal\u0131klar\u0131yla benzerlikler g\u00f6sterir ancak \u00e7e\u015fitli a\u00e7\u0131lardan farkl\u0131l\u0131k g\u00f6sterir.<\/li>\n\n\n\n<li class=\"\">DISH, 60&#8217;l\u0131 ve 70&#8217;li ya\u015flardaki hastalar\u0131 etkileyen bir ya\u015fl\u0131 hastal\u0131\u011f\u0131d\u0131r. Erkekler kad\u0131nlardan daha fazla etkilenmektedir. Ya\u015fl\u0131 erkeklerin yakla\u015f\u0131k %10&#8217;unda DISH olabilece\u011fi tahmin edilmektedir. Bununla birlikte, ciddi ailesel vakalarda baz\u0131 hastalar bu durumu 30&#8217;lu ya\u015flar\u0131nda geli\u015ftirebilir.  <\/li>\n\n\n\n<li class=\"\">Bu durum \u00f6ncelikle omurgan\u0131n torasik ve servikal b\u00f6lgelerini etkiler ve bu b\u00f6lgelerde a\u011fr\u0131 ve sertli\u011fe yol a\u00e7ar. Omurgan\u0131n \u00f6n taraf\u0131ndaki osteofitler yemek borusu veya sempatik sinirler gibi hayati yap\u0131lara bask\u0131 yapabilir.<\/li>\n\n\n\n<li class=\"\">DISH&#8217;in te\u015fhisi \u00f6ncelikle g\u00f6r\u00fcnt\u00fcleme \u00e7al\u0131\u015fmalar\u0131yla, omurga boyunca ve di\u011fer b\u00f6lgelerde kemik \u00e7\u0131k\u0131nt\u0131lar\u0131 veya osteofit olu\u015fumunu ortaya \u00e7\u0131karan r\u00f6ntgen filmleriyle yap\u0131l\u0131r.<\/li>\n\n\n\n<li class=\"\">DISH \u00f6nemli hareketlilik sorunlar\u0131na yol a\u00e7abilir ve ciddi vakalarda potansiyel olarak bir engellilik olarak nitelendirilebilir.<\/li>\n<\/ul>\n\n<p class=\"\"><\/p>\n\n<p class=\"\">Bu makalede, diff\u00fcz idiyopatik iskelet hiperostozunun (DISH) ne oldu\u011funu a\u00e7\u0131klayacak ve yeni kemik olu\u015fumunun klinik semptomlara nas\u0131l katk\u0131da bulundu\u011funu inceleyece\u011fiz. Ayr\u0131ca DISH ve di\u011fer tip idiyopatik artritlerin yan\u0131 s\u0131ra spondilit ve DISH aras\u0131ndaki farklar\u0131 ve bu durumun g\u00fcnl\u00fck ya\u015fam\u0131 nas\u0131l etkileyebilece\u011fini inceleyece\u011fiz.<\/p>\n\n<h2 class=\"wp-block-heading\" id=\"h-what-is-dish-disease\">DISH Hastal\u0131\u011f\u0131 nedir?<\/h2>\n\n<p class=\"\">Diff\u00fcz idiyopatik iskelet hiperostozu olarak da bilinen DISH, entezis olarak bilinen ba\u011f ve tendonlar\u0131n giri\u015f noktalar\u0131nda kalsifikasyon ve ekstra kemik dokusu olu\u015fumu ile kendini g\u00f6steren yayg\u0131n bir kemik hastal\u0131\u011f\u0131d\u0131r. DISH sertlik ve rahats\u0131zl\u0131\u011fa yol a\u00e7arak s\u0131kl\u0131kla s\u0131rt ve boyun problemlerine neden olur. Bu omurga rahats\u0131zl\u0131\u011f\u0131, semptomlar\u0131nda artriti and\u0131ran belirgin sertlik ve a\u011fr\u0131ya yol a\u00e7abilir, bu da baz\u0131lar\u0131n\u0131n DISH artriti terimini kullanmas\u0131na neden olmu\u015ftur.<\/p>\n\n<p class=\"\">Klinik belirtilerine ra\u011fmen, DISH&#8217;in kesin nedeni belirsizli\u011fini korumaktad\u0131r, bu nedenle ad\u0131ndaki<a href=\"https:\/\/www.merriam-webster.com\/dictionary\/idiopathic\" target=\"_blank\" rel=\"noopener\">&#8220;idiyopatik<\/a>&#8221; ifadesi bilinmeyen bir k\u00f6kene i\u015faret etmektedir. Di\u011fer kemik hastal\u0131klar\u0131n\u0131n aksine, DISH \u00f6zellikle ba\u011flar\u0131n ve tendonlar\u0131n omurgaya ba\u011fland\u0131\u011f\u0131 b\u00f6lgeleri (entezis) hedef al\u0131r ve hareketi k\u0131s\u0131tlayabilen kemik b\u00fcy\u00fcmelerine yol a\u00e7ar.<\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-is-dish-disease-a-disability\">DISH hastal\u0131\u011f\u0131 bir engellilik midir?<\/h3>\n\n<p class=\"\">DISH&#8217;in bir engellilik olarak nitelendirilip nitelendirilmeyece\u011fi sorusu, semptomlar\u0131n ciddiyetine ve bireyin g\u00fcnl\u00fck ya\u015fam\u0131 \u00fczerindeki etkisinin derecesine ba\u011fl\u0131d\u0131r. DISH&#8217;li baz\u0131 hastalar i\u00e7in bu durum \u00f6nemli hareketlilik sorunlar\u0131na yol a\u00e7abilir, g\u00fcnl\u00fck g\u00f6revlerini yerine getirme becerilerini ciddi \u015fekilde etkileyebilir ve dolay\u0131s\u0131yla potansiyel olarak bir engellilik olarak nitelendirilebilir.<\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-forestiers-disease-another-medical-term-for-dish\">Forestiers Hastal\u0131\u011f\u0131: DISH i\u00e7in Ba\u015fka Bir T\u0131bbi Terim<\/h3>\n\n<p class=\"\">Forestier Hastal\u0131\u011f\u0131, DISH i\u00e7in alternatif bir isimdir ve ad\u0131n\u0131 ilk kez 1950 y\u0131l\u0131nda <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4023007\/#:~:text=under%20the%20name%20%E2%80%9Csenile%20ankylosing%20vertebral%20hyperostosis%E2%80%9D\" target=\"_blank\" rel=\"noopener\">&#8220;senil ankilozan vertebral hiperostoz&#8221; ad\u0131 alt\u0131nda<\/a> tan\u0131mlayan Frans\u0131z doktor Jacques Forestier&#8217;den alm\u0131\u015ft\u0131r. <sup><a href=\"#footnote_1_2992\" id=\"identifier_1_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Forestier J, Rotes-Querol J. Senile ankylosing hyperostosis of the spine. Ann Rheum Dis. 1950;9(4): 321-330. https:\/\/doi.org\/10.1136\/ard.9.4.321\">1<\/a><\/sup> &#8220;Forestier Hastal\u0131\u011f\u0131&#8221; bazen DISH ile birbirinin yerine kullan\u0131lsa da, bu terimin \u00f6zellikle Dr. Forestier&#8217;in bu kemik hastal\u0131\u011f\u0131n\u0131n anla\u015f\u0131lmas\u0131na yapt\u0131\u011f\u0131 tarihsel katk\u0131y\u0131 vurgulad\u0131\u011f\u0131n\u0131 belirtmek \u00f6nemlidir. Baz\u0131 t\u0131p \u00e7evrelerinde bu durum, Forestier ve \u00f6\u011frencisi Jaume Rotes-Querol&#8217;un bu benzersiz t\u0131bbi durumu tan\u0131mlamadaki ortak \u00e7abalar\u0131na atfen &#8220;Forestier Sendromu&#8221; veya daha az yayg\u0131n olarak &#8220;Forestier-Rotes-Querol Sendromu&#8221; olarak da adland\u0131r\u0131labilir.<\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-ankylosing-hyperostosis\">Ankilozan Hiperostoz<\/h3>\n\n<p class=\"\">Omurgan\u0131n ankilozan hiperostozu, tarihsel olarak DISH veya Forestier hastal\u0131\u011f\u0131n\u0131 tan\u0131mlamak i\u00e7in kullan\u0131lan bir ba\u015fka terimdir. Omurgan\u0131n \u00f6n taraf\u0131 boyunca, \u00f6zellikle de torasik b\u00f6lgede a\u015f\u0131r\u0131 kemik b\u00fcy\u00fcmesini vurgular. Bu terim g\u00fcn\u00fcm\u00fczde daha az kullan\u0131lmaktad\u0131r ve tercih edilen terminoloji DISH veya diff\u00fcz idiyopatik iskelet hiperostozudur.<\/p>\n\n<h2 class=\"wp-block-heading\" id=\"h-how-serious-is-dish-disease\">DISH hastal\u0131\u011f\u0131 ne kadar ciddidir?<\/h2>\n\n<p class=\"\">DISH hastal\u0131\u011f\u0131n\u0131n \u015fiddeti bireyler aras\u0131nda \u00f6nemli \u00f6l\u00e7\u00fcde de\u011fi\u015febilir. Baz\u0131 durumlarda, g\u00fcnl\u00fck aktiviteler \u00fczerinde \u00e7ok az etkisi olan s\u0131rt veya boyunda hafif bir rahats\u0131zl\u0131k olarak ortaya \u00e7\u0131kabilir. Ancak hastal\u0131k ilerledik\u00e7e omurgada \u00f6nemli \u00f6l\u00e7\u00fcde hareket kayb\u0131, a\u011fr\u0131 ve yutma g\u00fc\u00e7l\u00fc\u011f\u00fc gibi daha ciddi komplikasyonlara yol a\u00e7abilir. Bu komplikasyonlar, DISH&#8217;li hastalar\u0131n ya\u015fam kalitesini ciddi \u015fekilde etkileyebilir ve rutin g\u00f6revlerini yerine getirmelerini zorla\u015ft\u0131rabilir. DISH hastal\u0131\u011f\u0131n\u0131n ciddiyeti, kemik b\u00fcy\u00fcmesinin derecesi, omurgan\u0131n etkilenen b\u00f6lgeleri ve di\u011fer sa\u011fl\u0131k ko\u015fullar\u0131n\u0131n varl\u0131\u011f\u0131 gibi fakt\u00f6rlerden etkilenir.<\/p>\n\n<h2 class=\"wp-block-heading\" id=\"h-spinal-segments-affected-by-dish\">DISH Taraf\u0131ndan Etkilenen Omurga Segmentleri<\/h2>\n\n<p class=\"\">DISH \u00f6ncelikle omurgan\u0131n torasik ve servikal b\u00f6lgelerini etkiler, lomber b\u00f6lge tutulumu daha az yayg\u0131nd\u0131r. DISH&#8217;de sakro-iliak eklemler korunur, bu da onu ankilozan spondilitten ay\u0131ran en \u00f6nemli \u00f6zelliktir.  <\/p>\n\n<figure class=\"wp-block-image aligncenter size-full\"><img decoding=\"async\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2024\/04\/DISH-in-the-Thoracic-and-Cervical-Regions-11.jpeg\" alt=\"DISH hastal&#x131;&#x11F;&#x131;ndan en s&#x131;k etkilenen servikal ve torasik omurgan&#x131;n g&#xF6;sterimi.\" class=\"wp-image-5249\"\/><figcaption class=\"wp-element-caption\"><em>Servikal ve torasik omurga DISH hastal\u0131\u011f\u0131ndan en s\u0131k etkilenen<\/em> b\u00f6lgelerdir.<\/figcaption><\/figure>\n\n<h3 class=\"wp-block-heading\" id=\"h-dish-in-the-thoracic-spine\">Torasik Omurgada DISH<\/h3>\n\n<p class=\"\">Torasik omurgadaki DISH veya torasik DISH, hastal\u0131\u011f\u0131n en s\u0131k g\u00f6r\u00fclen belirtisidir. Bu iskelet durumu, omurgan\u0131n <a href=\"https:\/\/en.wikipedia.org\/wiki\/Anterior_longitudinal_ligament\" target=\"_blank\" rel=\"noopener\">\u00f6n (\u00f6n<\/a>) y\u00fczeyinde <a href=\"https:\/\/en.wikipedia.org\/wiki\/Anterior_longitudinal_ligament\" target=\"_blank\" rel=\"noopener\">anterior longitudinal ligament<\/a> boyunca kemik \u00e7\u0131k\u0131nt\u0131lar\u0131n\u0131n (osteofit) olu\u015fmas\u0131na yol a\u00e7ar. Torasik omurga, omurgan\u0131n di\u011fer k\u0131s\u0131mlar\u0131na k\u0131yasla s\u0131n\u0131rl\u0131 hareket kabiliyeti nedeniyle DISH&#8217;e kar\u015f\u0131 \u00f6zellikle hassast\u0131r. DISH genellikle torasik omurgan\u0131n alt k\u0131sm\u0131nda (T5-11) daha \u015fiddetlidir. Alt torasik osteofitlerin karakteristik \u00f6zelli\u011fi asimetrik g\u00f6r\u00fcn\u00fcmleridir, yani sadece sa\u011f tarafta geli\u015firler. Sa\u011f taraf\u0131n neden daha fazla etkilendi\u011fi bilinmemekle birlikte, baz\u0131 ara\u015ft\u0131rmac\u0131lar sol tarafta aort varl\u0131\u011f\u0131n\u0131n yeni kemik olu\u015fumunu engelledi\u011fini \u00f6ne s\u00fcrmektedir. <sup><a href=\"#footnote_2_2992\" id=\"identifier_2_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Nathan H. Osteophytes of the spine compressing the sympathetic trunk and splanchnic nerves in the thorax. Spine (Phila Pa 1976). 1987;12(6): 527-532. https:\/\/doi.org\/10.1097\/00007632-198707000-00003\">2<\/a><\/sup> Bu hipotez yak\u0131n zamanda yap\u0131lan bir \u00e7al\u0131\u015fmada do\u011frulanm\u0131\u015ft\u0131r. <sup><a href=\"#footnote_3_2992\" id=\"identifier_3_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Chen H, Zhou Q, Wang S, et al. Not All Osteophytes Are Located on the Right Side of the Vertebrae in Diffuse Idiopathic Skeletal Hyperostosis: A Quantitative Analysis in Relation to the Position of Aorta. Orthop Surg.2023;15(11): 2881-2888. https:\/\/doi.org\/10.1111\/os.13869\">3<\/a><\/sup> <\/p>\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img decoding=\"async\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2024\/05\/Screenshot-2024-05-19-at-7.22.49&#x202F;PM.png\" alt=\"\" class=\"wp-image-5554\" style=\"width:618px;height:auto\"\/><figcaption class=\"wp-element-caption\">DISH&#8217;de alt torasik osteofitin tipik g\u00f6r\u00fcn\u00fcm\u00fc. Osteofitin (beyaz ok) solda inen aortun (daire i\u00e7inde g\u00f6sterilen) kar\u015f\u0131s\u0131nda sa\u011f tarafta oldu\u011funa dikkat edin. Radyolojik g\u00f6r\u00fcnt\u00fclerin ayna g\u00f6r\u00fcnt\u00fcs\u00fc oldu\u011funu, yani hastan\u0131n sa\u011f\u0131n\u0131n g\u00f6r\u00fcnt\u00fcde sol oldu\u011funu unutmay\u0131n.  <\/figcaption><\/figure>\n\n<p class=\"\">Aort, lomber b\u00f6lgede omurgan\u0131n \u00f6n taraf\u0131na do\u011fru pozisyon de\u011fi\u015ftirir ve bu nedenle bu b\u00f6lgedeki osteofitler bilateral olarak (yani hem sol hem de sa\u011f tarafta) geli\u015fir. Aorttan gelen pulsasyonlar\u0131n kalsiyum birikimine ve ard\u0131ndan kemikle\u015fmeye m\u00fcdahale etti\u011fine inan\u0131lmaktad\u0131r. Torasik omurgan\u0131n \u00fcst k\u0131sm\u0131 &#8211; T1-5 seviyeleri, alt k\u0131sma g\u00f6re daha az etkilenir. Ancak, DISH \u00fcst k\u0131s\u0131mda mevcutsa, aort yoklu\u011fu nedeniyle kemik spurlar\u0131 simetrik olarak b\u00fcy\u00fcme e\u011filimindedir.<\/p>\n\n<figure class=\"wp-block-image aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2024\/05\/Screenshot-2024-05-19-at-7.17.05&#x202F;PM-1024x1013.png\" alt=\"\" class=\"wp-image-5559\" style=\"width:670px;height:auto\"\/><figcaption class=\"wp-element-caption\">Torako-lomber b\u00f6lgede aorta (kesikli daire) daha merkezi konuma kayar ve bu nedenle osteofitler (beyaz oklar) simetrik olarak geli\u015fir. Aort alt\u0131ndaki alan\u0131n (sar\u0131 e\u011fri) osteofit i\u00e7ermedi\u011fine dikkat edin.  <\/figcaption><\/figure>\n\n<p class=\"\">Kemik \u00e7\u0131k\u0131nt\u0131lar\u0131 omur u\u00e7 plaklar\u0131ndan b\u00fcy\u00fcr. Omurlar aras\u0131 disk eklemleri etkilenmez. \u00dcst ve alt vertebradan gelen osteofitler birle\u015febilir ve sa\u011f \u00f6n y\u00fczey boyunca kemik k\u00f6pr\u00fcleri olu\u015fturabilir. Sonu\u00e7 olarak, omur kemikleri kayna\u015f\u0131r ve bu da omurga hareketlili\u011fini \u00f6nemli \u00f6l\u00e7\u00fcde azalt\u0131r. Tipik olarak, birka\u00e7 omur kemi\u011fi uzun ve hareketsiz bir segmentte birle\u015fir. Radyolojik olarak bu segment r\u00f6ntgen veya BT taramas\u0131nda klasik dalga benzeri g\u00f6r\u00fcn\u00fcme sahiptir.<\/p>\n\n<figure class=\"wp-block-image aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2024\/05\/Screenshot-2024-05-18-at-6.11.24&#x202F;PM-847x1024.png\" alt=\"\" class=\"wp-image-5527\" style=\"width:572px;height:auto\"\/><figcaption class=\"wp-element-caption\">DISH&#8217;de torasik osteofitlerin tipik bir g\u00f6r\u00fcn\u00fcm\u00fc. Baz\u0131lar\u0131n\u0131n birle\u015ferek tipik &#8220;dalga benzeri&#8221; bir g\u00f6r\u00fcn\u00fcm olu\u015fturdu\u011funa dikkat edin. Di\u011ferleri birle\u015fmez ve &#8220;ku\u015f gagas\u0131&#8221; \u015feklindedir.<\/figcaption><\/figure>\n\n<p class=\"\">Torasik omurga DISH&#8217;i olan bireyler s\u0131rt a\u011fr\u0131s\u0131, hareket a\u00e7\u0131kl\u0131\u011f\u0131nda azalma ve ciddi vakalarda g\u00f6\u011f\u00fcs kafesinin tutulmas\u0131 nedeniyle nefes almada zorluk gibi semptomlar ya\u015farlar. A\u011fr\u0131, omurga boyunca orta hatta veya omurgan\u0131n yan taraf\u0131nda hissedilir. Kemik \u00e7\u0131k\u0131nt\u0131lar\u0131 yak\u0131ndaki yap\u0131lara bask\u0131 yapabilir ve i\u015flev bozuklu\u011funa neden olabilir. Nadir de olsa \u00f6zofagus s\u0131k\u0131\u015fmas\u0131 bildirilmi\u015ftir. <sup><a href=\"#footnote_4_2992\" id=\"identifier_4_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Pongmanee S, Rojdumrongrattana B, Kritworakarn N, Sarasombath P, Liawrungrueang W. An unusual presentation of thoracic diffuse idiopathic skeletal hyperostosis (DISH) and video-assisted thoracoscopic surgery (VATS). Int J Surg Case Rep. 2022;93: 106993. https:\/\/doi.org\/10.1016\/j.ijscr.2022.106993\">4<\/a><\/sup> \u00c7ok daha yayg\u0131n olarak osteofitler torasik omurgan\u0131n \u00f6n y\u00fczeyi boyunca ge\u00e7en sempatik splanknik ve kardiyopulmoner sinirlere bas\u0131 yapar. <sup><a href=\"#footnote_2_2992\" id=\"identifier_5_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Nathan H. Osteophytes of the spine compressing the sympathetic trunk and splanchnic nerves in the thorax. Spine (Phila Pa 1976). 1987;12(6): 527-532. https:\/\/doi.org\/10.1097\/00007632-198707000-00003\">2<\/a><\/sup> Sempatik sinirlerin s\u0131k\u0131\u015fmas\u0131 belirgin otonomik tipte a\u011fr\u0131ya neden olabilir. A\u011fr\u0131 yo\u011fundur ve s\u0131kl\u0131kla yanma ile ili\u015fkilidir. Is\u0131nma, so\u011fukluk ve terleme gibi di\u011fer sempatik fenomenler de yayg\u0131nd\u0131r. Sempatik sinirler i\u00e7 organlar\u0131 innerve eder ve s\u0131k\u0131\u015fmalar\u0131 gastrointestinal rahats\u0131zl\u0131k, kar\u0131n a\u011fr\u0131s\u0131, kardiyak aritmi gibi i\u00e7 organlar\u0131n i\u015flev bozuklu\u011fuyla ilgili bir dizi semptom \u00fcretebilir. <sup><a href=\"#footnote_5_2992\" id=\"identifier_6_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Mader R, Dubenski N, Lavi I. Morbidity and mortality of hospitalized patients with diffuse idiopathic skeletal hyperostosis. Rheumatol Int. 2005;26(2): 132-136. https:\/\/doi.org\/10.1007\/s00296-004-0529-y)) etc. Bu osteofitlerin cerrahi olarak &ccedil;\u0131kar\u0131lmas\u0131, splanknik sinirler &uuml;zerindeki bask\u0131y\u0131 hafifletir ve &ouml;nemli &ouml;l&ccedil;&uuml;de iyile\u015fme sa\u011flar. ((Jankowski J, Pawelczyk A, Radek M. Thoracic osteophyte as a cause of symptomatic greater splanchnic nerve compression. Case report. Neurochirurgie. 2022;68(2): 232-234. https:\/\/doi.org\/10.1016\/j.neuchi.2021.02.017\">5<\/a><\/sup> <\/p>\n\n<p class=\"\">Omurgan\u0131n esnekli\u011fini kaybetmesi ve sertli\u011finin artmas\u0131 muhtemelen DISH&#8217;in en \u00f6nemli \u00f6zelli\u011fidir. Hareket segmenti ba\u015f\u0131na fizyolojik hareket aral\u0131\u011f\u0131 servikal ve lomber b\u00f6lgelere g\u00f6re daha d\u00fc\u015f\u00fckt\u00fcr. Bununla birlikte, daha fazla say\u0131da torasik omur (servikalde 12&#8217;ye kar\u015f\u0131 7 ve lomberde 5) bile\u015fik etki yarat\u0131r, yani k\u00fc\u00e7\u00fck bireysel hareketler toplan\u0131r ve \u00f6nemli bir genel hareket aral\u0131\u011f\u0131 olu\u015fturur. <sup><a href=\"#footnote_6_2992\" id=\"identifier_7_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Borkowski SL, Tamrazian E, Bowen RE, Scaduto AA, Ebramzadeh E, Sangiorgio SN. Challenging the Conventional Standard for Thoracic Spine Range of Motion: A Systematic Review. JBJS Rev. 2016;4(4): e51-e511. https:\/\/doi.org\/10.2106\/JBJS.RVW.O.00048\">6<\/a><\/sup>  Ek olarak, DISH servikal ve lomber segmentlere uzanabilir ve \u00e7ok \u00f6nemli genel hareket k\u0131s\u0131tlamas\u0131na neden olabilir. Omurgan\u0131n hareket kabiliyetinin kayb\u0131, hastal\u0131\u011f\u0131n morbiditesine katk\u0131da bulunan \u00f6nemli bir fakt\u00f6rd\u00fcr. Ancak hastalar sertli\u011fi hastal\u0131kla ili\u015fkilendirmeyebilir ve ya\u015flanman\u0131n bir par\u00e7as\u0131 olarak g\u00f6rebilir. Omurga sertli\u011finin artmas\u0131n\u0131n iki \u00f6nemli sonucu vard\u0131r<\/p>\n\n<ol class=\"wp-block-list\">\n<li class=\"\">Di\u011fer hareket segmentlerine artan dinamik y\u00fck ve ard\u0131ndan h\u0131zlanan dejenerasyon. Bir segmentteki hareket azalmas\u0131n\u0131n kom\u015fu eklemlerde telafi edici bir art\u0131\u015fa yol a\u00e7t\u0131\u011f\u0131 iyi bilinmektedir. Sonu\u00e7 olarak bu seviyelere binen dinamik y\u00fck artar ve intervertebral disk eklemleri daha h\u0131zl\u0131 dejenere olur. <sup><a href=\"#footnote_7_2992\" id=\"identifier_8_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Nakasuka M, Morino T, Hino M, Misaki H, Murakami Y, Miura H. Diffuse idiopathic skeletal hyperostosis: A potential factor in the induction of thoracic spondylotic myelopathy. J Orthop Sci. 2021;26(1): 75-78. https:\/\/doi.org\/10.1016\/j.jos.2020.01.009\">7<\/a><\/sup> Disk herniasyonlar\u0131, stenoz ve y\u00fcksek strese ba\u011fl\u0131 segmental instabilite, DISH hastalar\u0131nda \u00f6zellikle kayna\u015fm\u0131\u015f segmentin alt k\u0131sm\u0131nda s\u0131k g\u00f6r\u00fclen bulgulard\u0131r. <sup><a href=\"#footnote_8_2992\" id=\"identifier_9_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Yamada K, Satoh S, Hashizume H, et al. Diffuse idiopathic skeletal hyperostosis is associated with lumbar spinal stenosis requiring surgery. J Bone Miner Metab. 2019;37(1): 118-124. https:\/\/doi.org\/10.1007\/s00774-017-0901-0\">8<\/a><\/sup>  H\u0131zlanan dejenerasyonun bir sonucu olarak omurilik ve sinirlerin s\u0131k\u0131\u015fmas\u0131 DISH hastalar\u0131nda nadir de\u011fildir.<\/li>\n\n\n\n<li class=\"\">K\u00fc\u00e7\u00fck travmalarda bile omurga k\u0131r\u0131\u011f\u0131 riskinde art\u0131\u015f. Kayna\u015fm\u0131\u015f omur g\u00f6vdeleri uzun bir konsol kol olu\u015fturur. K\u0131sa bir sopadan \u00e7ok daha kolay k\u0131r\u0131labilen uzun bir sopa gibi, bu uzun sert segment de d\u00fc\u015f\u00fck enerjili darbelerde bile k\u0131r\u0131lmaya e\u011filimlidir. <sup><a href=\"#footnote_9_2992\" id=\"identifier_10_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Murakami Y, Mashima N, Morino T, et al. Association Between Vertebral Fracture and Diffuse Idiopathic Skeletal Hyperostosis. Spine (Phila Pa 1976). 2019;44(18): E1068-E1074. https:\/\/doi.org\/10.1097\/BRS.0000000000003151\">9<\/a><\/sup> <\/li>\n<\/ol>\n\n<h3 class=\"wp-block-heading\" id=\"h-dish-in-the-cervical-spine\">Servikal Omurgada DISH<\/h3>\n\n<p class=\"\">Servikal omurgan\u0131n DISH&#8217;i, hastal\u0131\u011f\u0131n bir di\u011fer yayg\u0131n belirtisidir. Hastal\u0131\u011f\u0131n bu formu anterior longitudinal ligamentin kalsifikasyonuna ve kemikle\u015fmesine yol a\u00e7ar. Yeni olu\u015fan osteofitler omur kemiklerinden d\u0131\u015far\u0131 do\u011fru \u00e7\u0131k\u0131nt\u0131 yapar ve s\u0131kl\u0131kla birle\u015ferek kemik k\u00f6pr\u00fcleri olu\u015fturur. Baz\u0131 durumlarda bu k\u00f6pr\u00fcler birka\u00e7 omur \u00fczerinde uzan\u0131r ve onlar\u0131 kayna\u015ft\u0131r\u0131r. Alt torasik osteofitlerin aksine bu kemik \u00e7\u0131k\u0131nt\u0131lar\u0131 olduk\u00e7a simetriktir. Boyun omurgas\u0131 ba\u015f\u0131n desteklenmesi ve hareketlerinin s\u00fcrd\u00fcr\u00fclmesi i\u00e7in \u00e7ok \u00f6nemlidir, bu nedenle bu segmentteki DISH bireyin g\u00fcnl\u00fck aktivitelerini ger\u00e7ekle\u015ftirme becerisini \u00f6nemli \u00f6l\u00e7\u00fcde etkiler.  <\/p>\n\n<p class=\"\">Servikal DISH&#8217;in belirtileri aras\u0131nda boyun a\u011fr\u0131s\u0131 ve boyun hareketlili\u011finde azalma yer al\u0131r. Ciddi vakalarda osteofitler o kadar b\u00fcy\u00fcyebilir ki omurgan\u0131n hemen \u00f6n\u00fcnde yer alan yemek borusu ve\/veya soluk borusuna bask\u0131 yapabilir. Bu durumlarda hastalar, d\u0131\u015f mekanik t\u0131kan\u0131kl\u0131k nedeniyle yutma (disfaji) veya nefes alma g\u00fc\u00e7l\u00fc\u011f\u00fc ya\u015farlar. <sup><a href=\"#footnote_10_2992\" id=\"identifier_11_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Harlianto NI, Kuperus JS, Mohamed Hoesein FAA, et al. Diffuse idiopathic skeletal hyperostosis of the cervical spine causing dysphagia and airway obstruction: an updated systematic review. Spine J. 2022;22(9): 1490-1503. https:\/\/doi.org\/10.1016\/j.spinee.2022.03.002\">10<\/a><\/sup> <\/p>\n\n<p class=\"\">Kayna\u015fm\u0131\u015f servikal vertebra uzun ve hareketsiz bir segment olu\u015fturur. Sonu\u00e7 olarak \u00fcst ve \u00f6zellikle alt intervertebral disk eklemleri daha y\u00fcksek dinamik y\u00fcke maruz kal\u0131r. Bu ekstra mekanik stres, bir\u00e7ok ya\u015fl\u0131 insanda zaten mevcut olan dejenerasyonu h\u0131zland\u0131r\u0131r. Dejenerasyonun derecesi o kadar \u015fiddetli olabilir ki omurilik (miyelopati) ve\/veya servikal spinal sinir k\u00f6kleri (radik\u00fclopati) s\u0131k\u0131\u015fabilir. Dejeneratif miyelo ve radik\u00fclopati semptomlar\u0131 aras\u0131nda kol ve bacaklarda a\u011fr\u0131, uyu\u015fma, g\u00fc\u00e7s\u00fczl\u00fck, dengesiz y\u00fcr\u00fcme ve ciddi vakalarda idrar ka\u00e7\u0131rma yer al\u0131r.  <\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-dish-in-the-lumbar-spine\">Lomber Omurgada DISH<\/h3>\n\n<p class=\"\">Torasik ve servikal segmentler kadar s\u0131k olmasa da diff\u00fcz idiyopatik iskelet hiperostozu lomber omurgay\u0131 da etkileyebilir. Torasik ve servikal omurgada oldu\u011fu gibi anterior longitudinal ligamentin kalsifikasyonu ve ossifikasyonu hastal\u0131\u011f\u0131n ay\u0131rt edici \u00f6zelli\u011fidir. Aortun daha merkezi konumu nedeniyle, osteofitler lomber omurgada daha simetrik olma e\u011filimindedir. Ekstra kemik \u00e7\u0131k\u0131nt\u0131lar\u0131 kom\u015fu bel omurlar\u0131n\u0131 kayna\u015ft\u0131rabilir ve hareketsizli\u011fin azalmas\u0131na yol a\u00e7abilir. Lomber omurgan\u0131n olduk\u00e7a esnek oldu\u011fu ve v\u00fccudun ana y\u00fck ta\u015f\u0131y\u0131c\u0131 yap\u0131s\u0131 oldu\u011fu d\u00fc\u015f\u00fcn\u00fcld\u00fc\u011f\u00fcnde, bu t\u00fcr bir k\u0131s\u0131tlama etkilenmemi\u015f seviyelere ekstra mekanik stres uygulayarak dejenerasyonlar\u0131n\u0131 h\u0131zland\u0131r\u0131r. <sup><a href=\"#footnote_11_2992\" id=\"identifier_12_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Yamada K, Satoh S, Abe Y, Yanagibashi Y, Hyakumachi T, Masuda T. Diffuse Idiopathic Skeletal Hyperostosis Extended to the Lumbar Segment Is a Risk Factor of Reoperation in Patients Treated Surgically for Lumbar Stenosis. Spine (Phila Pa 1976). 2018;43(20): 1446-1453. https:\/\/doi.org\/10.1097\/BRS.0000000000002618\">11<\/a><\/sup><\/p>\n\n<figure class=\"wp-block-image aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2024\/05\/Screenshot-2024-05-19-at-7.18.55&#x202F;PM-710x1024.png\" alt=\"\" class=\"wp-image-5564\" style=\"width:520px;height:auto\"\/><figcaption class=\"wp-element-caption\">Lomber omurgan\u0131n DISH&#8217;i. L2 ve L3 aras\u0131ndaki &#8220;ku\u015f gagas\u0131&#8221; benzeri ostheofitlere dikkat edin (beyaz ok). Ayr\u0131ca L4&#8217;ten sakruma kadar b\u00fcy\u00fck posterior f\u00fczyon kitlesine dikkat edin. Bu hasta alt lomber omurgada \u00e7ok say\u0131da ba\u015far\u0131s\u0131z ameliyat ge\u00e7irmi\u015ftir.  <\/figcaption><\/figure>\n\n<p class=\"\">Bir\u00e7ok vakada lomber DISH, lomber dejeneratif stenoz ile birlikte g\u00f6r\u00fcl\u00fcr. Omurga cerrahlar\u0131 ameliyattan \u00f6nce DISH&#8217;i fark etmeyebilir veya g\u00f6rmezden gelebilir. Bununla birlikte, lomber stenoz nedeniyle ameliyat edilen hastalarda DISH varl\u0131\u011f\u0131 daha k\u00f6t\u00fc cerrahi sonu\u00e7larla ili\u015fkilendirilmi\u015ftir. <sup><a href=\"#footnote_12_2992\" id=\"identifier_13_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Otsuki B, Fujibayashi S, Tanida S, Shimizu T, Lyman S, Matsuda S. Outcomes of lumbar decompression surgery in patients with diffuse idiopathic skeletal hyperostosis (DISH). J Orthop Sci. 2019;24(6): 957-962. https:\/\/doi.org\/10.1016\/j.jos.2019.09.003\">12<\/a><\/sup> Bu nedenle DISH&#8217;in ameliyat \u00f6ncesinde tan\u0131nmas\u0131 omurga cerrahlar\u0131 i\u00e7in \u00e7ok \u00f6nemlidir.<\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-extraspinal-dish\">Ekstraspinal DISH<\/h3>\n\n<p class=\"\">DISH&#8217;in sistemik bir hastal\u0131k oldu\u011fu unutulmamal\u0131d\u0131r. Omurga en s\u0131k etkilenen iskelet yap\u0131s\u0131 olmas\u0131na ra\u011fmen di\u011fer kemikler de tutulabilir. Pelvis ve ekstremiteler s\u0131kl\u0131kla etkilenir ancak genellikle \u00e7ok fazla semptom olu\u015fturmaz<\/p>\n\n<ol class=\"wp-block-list\">\n<li class=\"\">Pelvis. Pelvik ve sakral ba\u011flar\u0131n kalsifikasyonlar\u0131 ve ossifikasyonlar\u0131 tipiktir. \u0130liolomber, sakro-tuber\u00f6z ve sakro-iliak ligamentler kalsifikasyon belirtileri g\u00f6sterir. Di\u011fer pelvik bulgular aras\u0131nda osteofit geli\u015fimi, d\u00fczensiz \u00e7\u0131k\u0131nt\u0131lar ve pubik simfiz \u00fczerinde k\u00f6pr\u00fc osteofitleri yer al\u0131r. <sup><a href=\"#footnote_13_2992\" id=\"identifier_14_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Resnick D, Shaul SR, Robins JM. Diffuse idiopathic skeletal hyperostosis (DISH): Forestier&rsquo;s disease with extraspinal manifestations. Radiology. 1975;115(3): 513-524. https:\/\/doi.org\/10.1148\/15.3.513\">13<\/a><\/sup> <\/li>\n\n\n\n<li class=\"\">Uzuvlar. \u00dcst ve alt ekstremite entezleri s\u0131kl\u0131kla etkilenir. Yayg\u0131n b\u00f6lgeler aras\u0131nda olekranon, patella, metakarpal kemikler ve falankslar bulunur. DISH&#8217;in s\u0131kl\u0131kla ellerde kemik osteofitleri ile karakterize olan osteoartrit (OA) ile birlikte g\u00f6r\u00fcld\u00fc\u011f\u00fc unutulmamal\u0131d\u0131r. Bununla birlikte, bu ekstra kemik \u00e7\u0131k\u0131nt\u0131lar\u0131n\u0131n boyutu ve say\u0131s\u0131 DISH ve OA hastalar\u0131nda sadece OA hastalar\u0131na g\u00f6re daha y\u00fcksektir.  <\/li>\n<\/ol>\n\n<h2 class=\"wp-block-heading\" id=\"h-diffuse-idiopathic-skeletal-hyperostosis-causes\">Yayg\u0131n \u0130diopatik \u0130skelet Hiperostozu Nedenleri<\/h2>\n\n<p class=\"\">Diff\u00fcz idiyopatik iskelet hiperostozunun (DISH) kesin nedenleri bilinmemektedir, bu da ismindeki &#8220;idiyopatik&#8221; terimine yans\u0131maktad\u0131r. Bununla birlikte, ara\u015ft\u0131rmac\u0131lar durumun geli\u015fimine katk\u0131da bulunabilecek \u00e7e\u015fitli fakt\u00f6rler tespit etmi\u015flerdir.  <\/p>\n\n<ol class=\"wp-block-list\">\n<li class=\"\">Genetik fakt\u00f6rler. DISH&#8217;de rol oynayan genetik fakt\u00f6rlere ili\u015fkin ara\u015ft\u0131rmalar, birka\u00e7 aday molek\u00fcl ve yola\u011f\u0131 ortaya \u00e7\u0131karm\u0131\u015ft\u0131r. COL6A1, FGF2, RSPO4, LEMD3, PPP2R2D, BMP4, ALK2, ENT1 DISH patogenezinde rol oynayan aday genlerdir. <sup><a href=\"#footnote_14_2992\" id=\"identifier_15_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Dabrowski M, Kubaszewski L. Diffuse Idiopathic Skeletal Hyperostosis of Cervical Spine with Dysphagia-Molecular and Clinical Aspects. Int J Mol Sci. 2021;22(8). https:\/\/doi.org\/10.3390\/ijms22084255.))\n\n\n\nEpigenetik fakt&ouml;rler. Genlerin d&uuml;zg&uuml;n i\u015fleyebilmesi i&ccedil;in d&uuml;zenlenmesi gerekir. Genlerin a\u015f\u0131r\u0131 ifade edilmesi ve az ifade edilmesi anormal fonksiyona neden olabilir. &Ccedil;e\u015fitli epigenetik fakt&ouml;rler varsay\u0131lm\u0131\u015ft\u0131r. DNA metilasyonu ve kodlamayan RNA (ncRNA), &ouml;zellikle de mikro RNA (miRNA) ekspresyonu &ouml;nerilmi\u015ftir.  \n\n\n\nMetabolik fakt&ouml;rler. Obezite, diyabet, hipertansiyon, dislipidemi ve DISH aras\u0131ndaki ili\u015fki iyi bilinmektedir. Ancak, DISH&rsquo;in bu ko\u015fullar\u0131n bir sonucu olarak m\u0131 yoksa ortak risk fakt&ouml;rlerine ba\u011fl\u0131 olarak m\u0131 geli\u015fti\u011fi bilinmemektedir. ((Mader R, Verlaan JJ, Buskila D. Diffuse idiopathic skeletal hyperostosis: clinical features and pathogenic mechanisms. Nat Rev Rheumatol. 2013;9(12): 741-750. https:\/\/doi.org\/10.1038\/nrrheum.2013.165\">14<\/a><\/sup><\/li>\n\n\n\n<li class=\"\">Ya\u015f ve cinsiyet. DISH a\u011f\u0131rl\u0131kl\u0131 olarak ya\u015fl\u0131 hastal\u0131\u011f\u0131d\u0131r ve erkeklerde daha s\u0131k g\u00f6r\u00fcl\u00fcr. Ya\u015flanmayla birlikte DISH insidans\u0131n\u0131n artt\u0131\u011f\u0131 iyi bir \u015fekilde bildirilmi\u015ftir. \u00d6zellikle 70 ya\u015f \u00fcst\u00fc ki\u015filer DISH&#8217;e yatk\u0131nd\u0131r, ancak ailesel vakalarda hastalar 30&#8217;lu ya\u015flar\u0131nda bile etkilenebilir.  <\/li>\n<\/ol>\n\n<h2 class=\"wp-block-heading\" id=\"h-dish-disease-symptoms\">DISH Hastal\u0131\u011f\u0131 Belirtileri<\/h2>\n\n<p class=\"\">Genel olarak, DISH&#8217;in semptomlar\u0131 durumun yerine ve ciddiyetine ba\u011fl\u0131 olarak de\u011fi\u015fir. Omurga tutulumu evrenseldir ve artm\u0131\u015f sertlik hastal\u0131\u011f\u0131n ay\u0131rt edici \u00f6zelli\u011fidir. Ancak DISH kronik bir hastal\u0131k oldu\u011fundan ve geli\u015fmesi uzun y\u0131llar ald\u0131\u011f\u0131ndan, hastalar durumlar\u0131n\u0131n fark\u0131nda olmayabilir ve\/veya bunu ya\u015flanmayla ili\u015fkilendirebilirler. DISH ilerledik\u00e7e, bu sertlik \u00f6nemli \u00f6l\u00e7\u00fcde hareket a\u00e7\u0131kl\u0131\u011f\u0131 kayb\u0131na yol a\u00e7arak g\u00fcnl\u00fck aktiviteleri zorla\u015ft\u0131rabilir.<\/p>\n\n<p class=\"\">Etkilenen b\u00f6lgede a\u011fr\u0131 \u00e7ok s\u0131k g\u00f6r\u00fclen bir semptomdur. Asl\u0131nda a\u011fr\u0131, ya\u015fam kalitesini etkileyen ve hastalar\u0131 t\u0131bbi tedavi aramaya zorlayan en \u00f6nemli fakt\u00f6rd\u00fcr. A\u011fr\u0131 genellikle do\u011frudan omurgan\u0131n orta hatt\u0131nda veya paramedyende (yani orta hatt\u0131n hemen solunda veya sa\u011f\u0131nda kalan b\u00f6lge) bulunur. Ba\u015flang\u0131\u00e7ta a\u011fr\u0131 steroid olmayan anti inflamatuar ila\u00e7larla (NSA\u0130\u0130) hafifletilebilir ancak daha sonra bunlara diren\u00e7li hale gelir. DISH pelvis ve\/veya ekstremiteleri etkiliyorsa etkilenen entezler de a\u011fr\u0131l\u0131 hale gelebilir.  <\/p>\n\n<p class=\"\">Osteofitlerin a\u015f\u0131r\u0131 b\u00fcy\u00fcmesi yak\u0131ndaki yap\u0131lar\u0131n s\u0131k\u0131\u015fmas\u0131na ve semptomlar\u0131n ortaya \u00e7\u0131kmas\u0131na neden olabilir. Servikal omurgada \u00f6zofagusa bas\u0131 tipiktir ve disfajiye yol a\u00e7ar. Torasik ve lomber omurgada osteofitler sempatik sinirlere bask\u0131 yapabilir ve kronik dayan\u0131lmaz sempatik a\u011fr\u0131 ve\/veya i\u00e7 organlarda i\u015flev bozuklu\u011funa neden olabilir.  <\/p>\n\n<h2 class=\"wp-block-heading\" id=\"h-dish-diagnosis-and-tests\">DISH Te\u015fhis ve Testleri<\/h2>\n\n<p class=\"\">Kapsaml\u0131 bir DISH tan\u0131s\u0131 tipik olarak t\u0131bbi \u00f6yk\u00fc incelemesi, fizik muayene ve radyografik analizin bir kombinasyonunu i\u00e7erir. DISH tan\u0131s\u0131 \u00f6ncelikle g\u00f6r\u00fcnt\u00fcleme \u00e7al\u0131\u015fmalar\u0131 ile do\u011frulan\u0131r. G\u00f6r\u00fcnt\u00fclemede DISH&#8217;in ay\u0131rt edici i\u015fareti, \u00f6zellikle torasik b\u00f6lgede belirgin olmak \u00fczere, omurgan\u0131n \u00f6n ve yan s\u0131n\u0131r\u0131 boyunca kalsifikasyon varl\u0131\u011f\u0131d\u0131r. Tan\u0131, Resnick ve Niwayama kriterleri olarak adland\u0131r\u0131lan d\u00f6rt veya daha fazla ard\u0131\u015f\u0131k vertebra boyunca s\u00fcrekli kalsifikasyon ve sakroiliak eklem tutulumunun olmamas\u0131 gibi belirli kriterler kar\u015f\u0131land\u0131\u011f\u0131nda do\u011frulan\u0131r. <sup><a href=\"#footnote_15_2992\" id=\"identifier_16_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Resnick D, Niwayama G. Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). Radiology. 1976;119(3): 559-568. https:\/\/doi.org\/10.1148\/119.3.559\">15<\/a><\/sup> Bu kriterler, hastal\u0131\u011f\u0131n belirlenmesinde ve di\u011fer benzer durumlardan ay\u0131rt edilmesinde \u00e7ok etkilidir. Ancak son zamanlarda, bu kriterlerin de\u011fi\u015ftirilmi\u015f bir versiyonu Oudkerk ve arkada\u015flar\u0131 taraf\u0131ndan \u00f6nerilmi\u015ftir. <sup><a href=\"#footnote_16_2992\" id=\"identifier_17_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Oudkerk SF, de Jong PA, Attrach M, et al, Diagnosis of diffuse idiopathic skeletal hyperostosis with chest computed tomography: inter-observer agreement, Eur Radiol. 2017;27(1): 188-194, https:\/\/doi.org\/10.1007\/s00330-016-4355-x\">16<\/a><\/sup> Bu kriterler, sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n DISH&#8217;i DISH radyografik bulgular\u0131n\u0131 taklit edebilen benzer hastal\u0131klardan ay\u0131rt edebilmeleri i\u00e7in \u00f6nemlidir.<\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-dish-x-ray\">DISH X-ray<\/h3>\n\n<p class=\"\">R\u00f6ntgen, yayg\u0131n idiyopatik iskelet hiperostozunun te\u015fhisinde \u00e7ok \u00f6nemli bir ara\u00e7t\u0131r. Bilgisayarl\u0131 tomografi (BT) ortaya \u00e7\u0131kmadan \u00f6nce tan\u0131 koymak i\u00e7in tek y\u00f6ntemdi. Asl\u0131nda, X-\u0131\u015f\u0131n\u0131 DISH i\u00e7in iyi bir tan\u0131sal duyarl\u0131l\u0131k ve \u00f6zg\u00fcll\u00fc\u011fe sahiptir. Tipik olarak omurgada, \u00f6n uzunlamas\u0131na ba\u011f boyunca kemik \u00e7\u0131k\u0131nt\u0131lar\u0131 ve kalsifikasyon olu\u015fumu gibi karakteristik de\u011fi\u015fiklikler ortaya \u00e7\u0131kar\u0131r. Bu de\u011fi\u015fiklikler en s\u0131k torasik omurgada g\u00f6r\u00fclmekle birlikte servikal ve lomber b\u00f6lgelerde de ortaya \u00e7\u0131kabilir. Omurga ba\u011flar\u0131 boyunca akan kemikle\u015fmenin r\u00f6ntgen bulgular\u0131 DISH i\u00e7in ay\u0131rt edicidir ve di\u011fer omurga hastal\u0131klar\u0131ndan ay\u0131rt edilmesine yard\u0131mc\u0131 olur.<\/p>\n\n<figure class=\"wp-block-image aligncenter size-full\"><img decoding=\"async\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2024\/04\/DISH-Xray.webp\" alt=\"DISH'in X-&#x131;&#x15F;&#x131;n&#x131; g&#xF6;sterimi.  \" class=\"wp-image-5253\"\/><figcaption class=\"wp-element-caption\">Tipik bir  <em>Servikal DISH&#8217;in r\u00f6ntgen g\u00f6r\u00fcnt\u00fcs\u00fc. Resim kredisi: www.orthobullets.com.<\/em><\/figcaption><\/figure>\n\n<h3 class=\"wp-block-heading\" id=\"h-computerized-tomography-ct-scan\">Bilgisayarl\u0131 tomografi (BT) taramas\u0131<\/h3>\n\n<p class=\"\">R\u00f6ntgen, DISH te\u015fhisi i\u00e7in m\u00fckemmel bir ara\u00e7 olmas\u0131na ra\u011fmen \u00e7e\u015fitli s\u0131n\u0131rlamalar\u0131 vard\u0131r. \u00d6rne\u011fin, birka\u00e7 spiral b\u00f6lgenin (\u00fcst torasik, torasik-lomber bile\u015fke) g\u00f6r\u00fcnt\u00fclenmesi sorunlu olabilir. Di\u011fer bir handikap ise 2 boyutlu do\u011fas\u0131d\u0131r, yani 3 boyutlu nesne tek bir y\u00fczey \u00fczerinde temsil edilir. BT taramas\u0131 \u00e7ok daha hassas g\u00f6r\u00fcnt\u00fcleme sa\u011flar. 3 boyutlu v\u00fccut, g\u00f6r\u00fcnt\u00fcy\u00fc 3 d\u00fczlemde ve hatta 3 boyutlu formatta yeniden yap\u0131land\u0131rmak i\u00e7in bir araya getirilebilen dilim dilim taran\u0131r. Bu \u015fekilde osteofitlerin tam \u015fekli, boyutu ve konumu \u00e7ok daha do\u011fru bir \u015fekilde g\u00f6r\u00fcnt\u00fclenebilir. Asl\u0131nda, Oudkerk ve arkada\u015flar\u0131 taraf\u0131ndan BT taramas\u0131na dayal\u0131 olarak \u00f6nerilen yeni modifiye kriterler. <sup><a href=\"#footnote_17_2992\" id=\"identifier_18_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Oudkerk SF, de Jong PA, Attrach M, et al. Diagnosis of diffuse idiopathic skeletal hyperostosis with chest computed tomography: inter-observer agreement. Eur Radiol. 2017;27(1): 188-194. https:\/\/doi.org\/10.1007\/s00330-016-4355-x\">17<\/a><\/sup> <\/p>\n\n<figure class=\"wp-block-image aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2024\/05\/Figure-1-1-e1741017890838.jpg\" alt=\"\" class=\"wp-image-5586\" style=\"width:597px;height:auto\"\/><figcaption class=\"wp-element-caption\">DISH&#8217;li bir hastan\u0131n 3 boyutlu torasik omurga BT rekonstr\u00fcksiyonu. Omurgan\u0131n sa\u011f \u00f6n taraf\u0131 boyunca DISH i\u00e7in tipik olan yo\u011fun, &#8220;ak\u0131c\u0131&#8221;, keskin osteofitlere dikkat edin.  <\/figcaption><\/figure>\n\n<h2 class=\"wp-block-heading\" id=\"h-dish-and-related-conditions\">DISH ve \u0130lgili Ko\u015fullar<\/h2>\n\n<p class=\"\">Diff\u00fcz \u0130diyopatik \u0130skelet Hiperostozu, di\u011fer bir\u00e7ok iskelet rahats\u0131zl\u0131\u011f\u0131 ile benzerlik g\u00f6stermekte ve ay\u0131r\u0131c\u0131 tan\u0131y\u0131 \u00e7ok \u00f6nemli hale getirmektedir. DISH ve ilgili durumlar aras\u0131ndaki farklar\u0131 anlamak, do\u011fru te\u015fhis ve uygun tedavi i\u00e7in \u00e7ok \u00f6nemlidir.<\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-dish-vs-ankylosing-spondylitis\">DISH vs Ankilozan Spondilit<\/h3>\n\n<figure class=\"wp-block-image aligncenter size-full\"><img decoding=\"async\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2024\/04\/DISH-vs-Ankylosing-Spondylitis-11.jpeg\" alt=\"Omurgan&#x131;n ankilozan spondilitinin g&#xF6;sterimi.\" class=\"wp-image-5257\"\/><figcaption class=\"wp-element-caption\"><em>Omurgan\u0131n ankilozan spondiliti<\/em>.<\/figcaption><\/figure>\n\n<p class=\"\">Hem DISH hem de ankilozan spondilit spontan spinal f\u00fczyonla sonu\u00e7lanan durumlard\u0131r, ancak farkl\u0131 \u00f6zelliklere sahiptirler. DISH, enflamasyonun olmamas\u0131, anterior longitudinal ligament boyunca kalsifikasyon ve sakroiliak eklem (SI) tutulumunun olmamas\u0131 ile karakterizedir (ancak SI eklem \u00e7evresindeki ligamentler s\u0131kl\u0131kla kalsifiye olur). Ankilozan spondilit (AS) ise \u00f6ncelikle sakroiliak eklemleri etkileyen ve omurgaya ilerleyerek omurlarda f\u00fczyona yol a\u00e7an iltihabi bir durumdur. AS&#8217;nin karakteristik \u00f6zelli\u011fi, tipik bambu omurga g\u00f6r\u00fcn\u00fcm\u00fcne yol a\u00e7an disk eklemlerinin simetrik tutulumudur. Belirgin omurga deformasyonu ankilozan spondilitin bir ba\u015fka \u00f6zelli\u011fidir ve DISH hastalar\u0131nda genellikle yoktur.<\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-disc-degeneration\">Disk dejenerasyonu<\/h3>\n\n<p class=\"\">\u0130ntervertebral disk dejenerasyonu, \u00f6zellikle ya\u015fl\u0131larda omurgay\u0131 etkileyen yayg\u0131n bir durumdur. DISH&#8217;e benzeyen \u00e7e\u015fitli \u00f6zelliklere sahip olabilir. Disk dejenerasyonunun ilerleyen a\u015famalar\u0131nda osteofit olu\u015fumu yayg\u0131nd\u0131r ve bu durum DISH&#8217;e benzer. Bununla birlikte, birka\u00e7 temel farkl\u0131l\u0131k vard\u0131r. En belirgin ayr\u0131m, dejeneratif disk hastal\u0131\u011f\u0131nda disk ekleminin belirgin dejenerasyonu ve disk aral\u0131\u011f\u0131n\u0131n daralmas\u0131d\u0131r. \u00d6te yandan bu disk alan\u0131 y\u00fcksekli\u011fi DISH&#8217;de iyi korunmu\u015ftur. Disk dejenerasyonunda osteofitler, hastal\u0131\u011f\u0131n en belirgin oldu\u011fu servikal ve lomber b\u00f6lgelerde daha fazla g\u00f6r\u00fclme e\u011filimindeyken, DISH genellikle torasik omurgay\u0131 etkiler. Ayr\u0131ca dejenerasyonla ili\u015fkili osteofitler genellikle izole edilir ve ilgili disklere do\u011frulan\u0131rken, DISH ile ili\u015fkili osteofitler birlikte k\u00fcmelenir. DISH&#8217;de faset eklemler genellikle korunurken, intervertebral disk eklemi dejenerasyonu bunlara ek y\u00fck bindirir ve hipertrofiye neden olur.  <\/p>\n\n<p class=\"\">DISH ve dejeneratif omurga hastal\u0131\u011f\u0131 aras\u0131ndaki ayr\u0131m genellikle net olsa da, bu iki durum ayn\u0131 hastada (ve genellikle) bir arada bulunabilir. DISH, omurgan\u0131n bir segmentinin kendili\u011finden kayna\u015fmas\u0131na yol a\u00e7ar ve kom\u015fu disk eklemlerinin dejenerasyonunu h\u0131zland\u0131r\u0131r. <sup><a href=\"#footnote_7_2992\" id=\"identifier_19_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Nakasuka M, Morino T, Hino M, Misaki H, Murakami Y, Miura H. Diffuse idiopathic skeletal hyperostosis: A potential factor in the induction of thoracic spondylotic myelopathy. J Orthop Sci. 2021;26(1): 75-78. https:\/\/doi.org\/10.1016\/j.jos.2020.01.009\">7<\/a><\/sup> Dejenere olmu\u015f diskin kendisi, spinal stenoza katk\u0131da bulunan osteofitler geli\u015ftirebilir. DISH&#8217;in lomber dejenerasyon i\u00e7in tetikleyici fakt\u00f6r olarak tan\u0131nmas\u0131 \u00e7ok \u00f6nemlidir, \u00e7\u00fcnk\u00fc cerrahi sonu\u00e7lar DISH olan ve olmayan hastalarda farkl\u0131l\u0131k g\u00f6sterir. <sup><a href=\"#footnote_12_2992\" id=\"identifier_20_2992\" class=\"footnote-link footnote-identifier-link\" title=\"Otsuki B, Fujibayashi S, Tanida S, Shimizu T, Lyman S, Matsuda S. Outcomes of lumbar decompression surgery in patients with diffuse idiopathic skeletal hyperostosis (DISH). J Orthop Sci. 2019;24(6): 957-962. https:\/\/doi.org\/10.1016\/j.jos.2019.09.003\">12<\/a><\/sup><\/p>\n\n<h2 class=\"wp-block-heading\" id=\"h-dish-prognosis\">DISH Prognozu<\/h2>\n\n<p class=\"\">DISH hastal\u0131\u011f\u0131 olan hastalar i\u00e7in prognoz, \u00f6zellikle durum erken te\u015fhis edildi\u011finde ve etkili bir \u015fekilde y\u00f6netildi\u011finde genellikle olumludur. Bununla birlikte, yutma g\u00fc\u00e7l\u00fc\u011f\u00fc veya sempatik sinir s\u0131k\u0131\u015fmas\u0131 gibi komplikasyonlar\u0131n varl\u0131\u011f\u0131 genel prognozu etkileyebilir. D\u00fczenli izleme ve semptom y\u00f6netimine proaktif bir yakla\u015f\u0131m, iyi bir ya\u015fam kalitesini s\u00fcrd\u00fcrmenin anahtar\u0131d\u0131r.<\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-how-fast-does-dish-disease-progress\">DISH hastal\u0131\u011f\u0131 ne kadar h\u0131zl\u0131 ilerler?<\/h3>\n\n<p class=\"\">DISH hastal\u0131\u011f\u0131n\u0131n ilerlemesi bireyler aras\u0131nda b\u00fcy\u00fck farkl\u0131l\u0131klar g\u00f6sterebilir. Bir\u00e7o\u011fu i\u00e7in hastal\u0131k yava\u015f ilerler ve semptomlar y\u0131llarca stabil kalabilir. Baz\u0131 vakalarda, durum ba\u015flang\u0131\u00e7taki tablonun \u00f6tesine \u00f6nemli \u00f6l\u00e7\u00fcde ge\u00e7meyebilir. Ancak di\u011ferlerinde hastal\u0131k zaman i\u00e7inde giderek k\u00f6t\u00fcle\u015ferek hareket kabiliyetinin azalmas\u0131na yol a\u00e7abilir. Ya\u015f, genel sa\u011fl\u0131k durumu ve ya\u015fam tarz\u0131 gibi fakt\u00f6rler ilerleme h\u0131z\u0131n\u0131 etkileyebilir. Hastal\u0131\u011f\u0131n ilerlemesini izlemek ve tedaviyi gerekti\u011fi gibi ayarlamak i\u00e7in bir sa\u011fl\u0131k uzman\u0131yla d\u00fczenli kontroller \u00f6nemlidir.<\/p>\n\n<h2 class=\"wp-block-heading\" id=\"h-conclusion-emerging-dish-treatment-methods-what-s-next\">Sonu\u00e7: Geli\u015fen DISH Tedavi Y\u00f6ntemleri &#8211; S\u0131rada Ne Var?<\/h2>\n\n<p class=\"\">DISH hastal\u0131\u011f\u0131na ili\u015fkin anlay\u0131\u015f\u0131m\u0131z geli\u015fmeye devam ettik\u00e7e, bu durumdan etkilenenler i\u00e7in mevcut tedavi y\u00f6ntemleri de geli\u015fmektedir. Geleneksel yakla\u015f\u0131mlar semptomlar\u0131 y\u00f6netmeye ve hareketlili\u011fi s\u00fcrd\u00fcrmeye odaklan\u0131rken, yeni ortaya \u00e7\u0131kan tedaviler ve ameliyat y\u00f6ntemleri daha hedefli ve etkili m\u00fcdahaleler sunmaktad\u0131r.  <\/p>\n\n<h2 class=\"wp-block-heading\" id=\"h-next-chapter-dish-disease-treatment-achieving-permanent-pain-relief-through-surgery\">Sonraki B\u00f6l\u00fcm: <a href=\"https:\/\/kamranaghayev.com\/tr\/dish-hastaligi-tedavisi\/\">DISH Hastal\u0131\u011f\u0131 Tedavisi &#8211; Ameliyat Yoluyla Kal\u0131c\u0131 A\u011fr\u0131 Giderimi Sa\u011flama<\/a><\/h2>\n\n<h2 class=\"wp-block-heading\" id=\"h-references\">Referanslar<\/h2>\n<ol class=\"footnotes\"><li id=\"footnote_1_2992\" class=\"footnote\">Forestier J, Rotes-Querol J. Senile ankylosing hyperostosis of the spine. <em>Ann Rheum Dis.<\/em> 1950;9(4): 321-330. <a href=\"https:\/\/doi.org\/10.1136\/ard.9.4.321\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1136\/ard.9.4.321<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_1_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_2992\" class=\"footnote\">Nathan H. Osteophytes of the spine compressing the sympathetic trunk and splanchnic nerves in the thorax. <em>Spine (Phila Pa 1976).<\/em> 1987;12(6): 527-532. <a href=\"https:\/\/doi.org\/10.1097\/00007632-198707000-00003\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1097\/00007632-198707000-00003<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_2_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_5_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_2992\" class=\"footnote\">Chen H, Zhou Q, Wang S, et al. Not All Osteophytes Are Located on the Right Side of the Vertebrae in Diffuse Idiopathic Skeletal Hyperostosis: A Quantitative Analysis in Relation to the Position of Aorta. <em>Orthop Surg.<\/em>2023;15(11): 2881-2888. <a href=\"https:\/\/doi.org\/10.1111\/os.13869\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1111\/os.13869<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_3_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_2992\" class=\"footnote\">Pongmanee S, Rojdumrongrattana B, Kritworakarn N, Sarasombath P, Liawrungrueang W. An unusual presentation of thoracic diffuse idiopathic skeletal hyperostosis (DISH) and video-assisted thoracoscopic surgery (VATS). <em>Int J Surg Case Rep.<\/em> 2022;93: 106993. <a href=\"https:\/\/doi.org\/10.1016\/j.ijscr.2022.106993\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1016\/j.ijscr.2022.106993<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_4_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_5_2992\" class=\"footnote\">Mader R, Dubenski N, Lavi I. Morbidity and mortality of hospitalized patients with diffuse idiopathic skeletal hyperostosis. <em>Rheumatol Int.<\/em> 2005;26(2): 132-136. <a href=\"https:\/\/doi.org\/10.1007\/s00296-004-0529-y\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1007\/s00296-004-0529-y<\/a>)) etc. Bu osteofitlerin cerrahi olarak \u00e7\u0131kar\u0131lmas\u0131, splanknik sinirler \u00fczerindeki bask\u0131y\u0131 hafifletir ve \u00f6nemli \u00f6l\u00e7\u00fcde iyile\u015fme sa\u011flar. ((Jankowski J, Pawelczyk A, Radek M. Thoracic osteophyte as a cause of symptomatic greater splanchnic nerve compression. Case report. <em>Neurochirurgie.<\/em> 2022;68(2): 232-234. <a href=\"https:\/\/doi.org\/10.1016\/j.neuchi.2021.02.017\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1016\/j.neuchi.2021.02.017<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_6_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_6_2992\" class=\"footnote\">Borkowski SL, Tamrazian E, Bowen RE, Scaduto AA, Ebramzadeh E, Sangiorgio SN. Challenging the Conventional Standard for Thoracic Spine Range of Motion: A Systematic Review. <em>JBJS Rev.<\/em> 2016;4(4): e51-e511. <a href=\"https:\/\/doi.org\/10.2106\/JBJS.RVW.O.00048\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.2106\/JBJS.RVW.O.00048<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_7_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_7_2992\" class=\"footnote\">Nakasuka M, Morino T, Hino M, Misaki H, Murakami Y, Miura H. Diffuse idiopathic skeletal hyperostosis: A potential factor in the induction of thoracic spondylotic myelopathy. <em>J Orthop Sci.<\/em> 2021;26(1): 75-78. <a href=\"https:\/\/doi.org\/10.1016\/j.jos.2020.01.009\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1016\/j.jos.2020.01.009<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_8_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_19_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_8_2992\" class=\"footnote\">Yamada K, Satoh S, Hashizume H, et al. Diffuse idiopathic skeletal hyperostosis is associated with lumbar spinal stenosis requiring surgery. <em>J Bone Miner Metab.<\/em> 2019;37(1): 118-124. <a href=\"https:\/\/doi.org\/10.1007\/s00774-017-0901-0\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1007\/s00774-017-0901-0<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_9_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_9_2992\" class=\"footnote\">Murakami Y, Mashima N, Morino T, et al. Association Between Vertebral Fracture and Diffuse Idiopathic Skeletal Hyperostosis. <em>Spine (Phila Pa 1976).<\/em> 2019;44(18): E1068-E1074. <a href=\"\">https:\/\/doi.org\/10.1097\/BRS.0000000000003151<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_10_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_10_2992\" class=\"footnote\">Harlianto NI, Kuperus JS, Mohamed Hoesein FAA, et al. Diffuse idiopathic skeletal hyperostosis of the cervical spine causing dysphagia and airway obstruction: an updated systematic review. <em>Spine J.<\/em> 2022;22(9): 1490-1503. <a href=\"https:\/\/doi.org\/10.1016\/j.spinee.2022.03.002\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1016\/j.spinee.2022.03.002<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_11_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_11_2992\" class=\"footnote\">Yamada K, Satoh S, Abe Y, Yanagibashi Y, Hyakumachi T, Masuda T. Diffuse Idiopathic Skeletal Hyperostosis Extended to the Lumbar Segment Is a Risk Factor of Reoperation in Patients Treated Surgically for Lumbar Stenosis. <em>Spine (Phila Pa 1976).<\/em> 2018;43(20): 1446-1453. <a href=\"https:\/\/doi.org\/10.1097\/BRS.0000000000002618\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1097\/BRS.0000000000002618<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_12_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_12_2992\" class=\"footnote\">Otsuki B, Fujibayashi S, Tanida S, Shimizu T, Lyman S, Matsuda S. Outcomes of lumbar decompression surgery in patients with diffuse idiopathic skeletal hyperostosis (DISH). <em>J Orthop Sci.<\/em> 2019;24(6): 957-962. <a href=\"https:\/\/doi.org\/10.1016\/j.jos.2019.09.003\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1016\/j.jos.2019.09.003<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_13_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_20_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_13_2992\" class=\"footnote\">Resnick D, Shaul SR, Robins JM. Diffuse idiopathic skeletal hyperostosis (DISH): Forestier&#8217;s disease with extraspinal manifestations. <em>Radiology.<\/em> 1975;115(3): 513-524. <a href=\"https:\/\/doi.org\/10.1148\/15.3.513\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1148\/15.3.513<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_14_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_14_2992\" class=\"footnote\">Dabrowski M, Kubaszewski L. Diffuse Idiopathic Skeletal Hyperostosis of Cervical Spine with Dysphagia-Molecular and Clinical Aspects. <em>Int J Mol Sci.<\/em> 2021;22(8). <a href=\"https:\/\/doi.org\/10.3390\/ijms22084255\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.3390\/ijms22084255<\/a>.))<\/li>\n\n\n\n<li class=\"\">Epigenetik fakt\u00f6rler. Genlerin d\u00fczg\u00fcn i\u015fleyebilmesi i\u00e7in d\u00fczenlenmesi gerekir. Genlerin a\u015f\u0131r\u0131 ifade edilmesi ve az ifade edilmesi anormal fonksiyona neden olabilir. \u00c7e\u015fitli epigenetik fakt\u00f6rler varsay\u0131lm\u0131\u015ft\u0131r. DNA metilasyonu ve kodlamayan RNA (ncRNA), \u00f6zellikle de mikro RNA (miRNA) ekspresyonu \u00f6nerilmi\u015ftir.  <\/li>\n\n\n\n<li class=\"\">Metabolik fakt\u00f6rler. Obezite, diyabet, hipertansiyon, dislipidemi ve DISH aras\u0131ndaki ili\u015fki iyi bilinmektedir. Ancak, DISH&#8217;in bu ko\u015fullar\u0131n bir sonucu olarak m\u0131 yoksa ortak risk fakt\u00f6rlerine ba\u011fl\u0131 olarak m\u0131 geli\u015fti\u011fi bilinmemektedir. ((Mader R, Verlaan JJ, Buskila D. Diffuse idiopathic skeletal hyperostosis: clinical features and pathogenic mechanisms. <em>Nat Rev Rheumatol.<\/em> 2013;9(12): 741-750. <a href=\"https:\/\/doi.org\/10.1038\/nrrheum.2013.165\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1038\/nrrheum.2013.165<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_15_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_15_2992\" class=\"footnote\">Resnick D, Niwayama G. Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). <em>Radiology.<\/em> 1976;119(3): 559-568. <a href=\"https:\/\/doi.org\/10.1148\/119.3.559\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1148\/119.3.559<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_16_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_16_2992\" class=\"footnote\">Oudkerk SF, de Jong PA, Attrach M, et al, Diagnosis of diffuse idiopathic skeletal hyperostosis with chest computed tomography: inter-observer agreement, <em>Eur Radiol.<\/em> 2017;27(1): 188-194, <a href=\"https:\/\/doi.org\/10.1007\/s00330-016-4355-x\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1007\/s00330-016-4355-x<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_17_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_17_2992\" class=\"footnote\">Oudkerk SF, de Jong PA, Attrach M, et al. Diagnosis of diffuse idiopathic skeletal hyperostosis with chest computed tomography: inter-observer agreement. <em>Eur Radiol.<\/em> 2017;27(1): 188-194. <a href=\"https:\/\/doi.org\/10.1007\/s00330-016-4355-x\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1007\/s00330-016-4355-x<\/a><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_18_2992\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>DISH hastal\u0131\u011f\u0131 nedir: belirtileri, tan\u0131s\u0131 ve DISH&#8217;in omurgay\u0131 nas\u0131l etkiledi\u011fi dahil olmak \u00fczere Diff\u00fcz \u0130diyopatik \u0130skelet Hiperostozu hakk\u0131nda ayr\u0131nt\u0131l\u0131 bilgi edinin.<\/p>\n","protected":false},"author":2,"featured_media":4037,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"content-type":"","footnotes":""},"categories":[24,31],"tags":[],"class_list":["post-2992","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hastaliklar","category-omurga-hastaliklari"],"acf":[],"_links":{"self":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts\/2992","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/comments?post=2992"}],"version-history":[{"count":0,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts\/2992\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/media\/4037"}],"wp:attachment":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/media?parent=2992"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/categories?post=2992"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/tags?post=2992"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}