All the affected individuals had ankylosing
vertebral hyperostosis, including ossification of paraspinal ligaments and
formation of large osteophytes. Most were asymptomatic; a few complained
about low-grade back pain. Tylosis was present in all patients. One member
had mild psoriasis. The osseous manifestations are basically identical to
those found in diffuse idiopathic skeletal hyperostosis (DISH), and some
researchers use Beardwell and Forestier syndrome synonymously. However,
although onset of DISH (ankylosing hyperostosis, asymmetrical skeletal hyperostosis or senile ankylosing hyperostosis) before 50 years of
age is exceedingly rare, affected individuals here were between 18 and 50 years
old at the time of the report. DISH often is asymptomatic, but many of the
different symptoms and complications reported are dependent on the location
of the osteophytes. The symptoms may range from pain and stiffness to
stridor and difficulties swallowing. Furthermore, a higher incidence of
diabetes mellitus and other metabolic disorders has been reported.