Manifestations of the diffuse idiopathic skeletal hyperostosis at the forefoot

Diffuse idiopathic skeletal hyperostosis (DISH) also becomes noticeable at the numerous entheses of the forefoot mainly with exomarginal formation of spongious bone. The separate enthese react differently to enthesiopathic stimuli. In DISH the tuberosities of the distal phalanges react most frequently and most severely. Between the toes and the digits there are differences in DISH not only of a quantitative but also of a qualitative nature. At the toes the increased subchondral sclerosis does not occur as it does at the digits. (orig.)