Forestier's disease: all you need to know about this rheumatological disorder

Share with your concerned loved ones
4.1
(9)

Unknown, the Forestier's disease is one of the most common forms of arthritis after osteoarthritis. It is found in people over the age of 60 and is more common in men than in women. Symptoms are usually characterized by pain and stiffness in the back areas, but with varying intensities from one person to another, which complicates the diagnosis. It is sometimes discovered only late.

The treatments for this pathology are purely symptomatic. They are only intended to relieve pain, reduce joint stiffness and remove organ compression that may be caused by the disease. We take stock of this rheumatological disorder in this article.

What is Forestier's disease?

La Forestier's disease ou Forestier and Rotès-Querol disease is a joint pathology that particularly affects the cervical and lumbar. It is also known by other names such ashyperostosis vertebral enveloping,hyperostosis vertebral ankylosing and melorheostosis vertebral. In English, we speak of Diffuse Idiopathic Skeletal Hyperostosis (DISH).

Unlike most arthritis, Forestier's disease does not cause inflammation. It translates into the calcification of ligaments and connective tissues which constitute the joints. The phenomenon leads to the formation of bony bridges between vertebrae which subsequently will limit the movements of the spine.

Other parts of the body can also undergo this calcification: the elbows, the knees and the heels. Within these joints, the disease manifests as formation of growths ou bone spines in the areas where tendons and ligaments connect with the bones.

What are the causes ?

Until now, we still do not know the true causes of Forestier's disease. Scientists only offer a few hypotheses about what could be the factors that promote its development.

Research on the disease has revealed that its incidence is linked with advancing age. It mainly affects people aged over 60 years. Among the sick, men are more numerous than women.

RECOMMENDED FOR YOU:  Forestier's disease: 5 possible complications (what to do?)

It has also been found that in people who have been diagnosed with Forest's disease, many suffer from diabetes. Diabetics constitute 25 to 50% of patients.

Other risk factors have also been found such as:

  • obesity ;
  • hyperuricemia : high level of uric acid in the body;
  • osteoarthritis back ;
  • the concentration in excess vitamin A in the body.

Hypotheses also support that the disease could have a genetic and ethnic origin. According to the information received, it affects approximately 15 to 25% of the North American population over the age of 50. On the other hand, the prevalence is lower among the other tribes.

What are the symptoms ?

In the early stages of its development, the Forestier's disease may be asymptomatic or show only mild signs of stiffness and pain in the neck and back. Many confuse them with simple ailments related to aging.

Over time, symptoms will appear more often. Stiffness is triggered in particular in the morning when waking up or after a prolonged position. Back pain can become chronic or remain intermittent, depending on the patient.

Accompanying these symptoms, the range of back motion also decreases. This can lead to disability, especially for patients whose work requires physical effort.

When bone spines manage to affect nearby organs, thehyperostosis vertebral worsens and various complications arise.

For example, it is possible that as they develop, the spines cause a narrowing of the spinal canal (canal lumbar ou cervical narrow) leading to nerve root compression (radiculopathy). This leads to a sciatica to cervico-brachial neuralgia. The patient also becomes more prone to suffer from muscle weakness and repeated pain in the arms and legs.

If the compression affects the esophagus, the patient may have difficulty swallowing food and liquids. We are talking about dysphagia.

More dangerous is the compression in the upper airways such as the pharynx, larynx or trachea. In this case, respiratory problems such as noisy breathing and sleep apnea may appear. In addition, the patient becomes more prone to saliva misdirection into the airways.

RECOMMENDED FOR YOU:  Forestier disease and diet: What you need to know

The risk of vertebral fractures also rises in patients with Forestier's disease.

It is important to emphasize that complications occur only very rarely. However, in order to limit the harmful consequences on health, it is better to consult a doctor quickly as soon as worrying signs appear.

How to make the diagnosis of Forestier's disease?

In general, the diagnosis always begins with a clinical examination. The doctor assesses the patient's painful symptoms and performs a series of examinations to rule out other possible causes of back pain.

To confirm that it is indeed Forestier's disease, it is then necessary to carry out imaging exams. Most often, X-rays of the spine or chest are used.

The result is positive for the existence of the following signs:

  • bony bridges on several vertebrae (greater than 4);
  • no lesions of intervertebral discs : lesions usually indicate other diseases;
  • spinal joints not fully welded.

In case of suspicion or obvious signs of complications, the doctor may prescribe a scan or MRI (Magnetic resonance imaging). These examinations are necessary to better observe the extent of the lesions and to set up the appropriate care.

There is, however, a slight drawback with imaging exams. They do not allow to visualize the characteristic signs in the early stages of the disease.

Personalized blood tests can also be used to look for signs of inflammation. In particular, they include measurements of the rate of C-reactive protein (CRP) and that of the erythrocyte sedimentation rate (ERS).

Moreover, electrolyte levels and growth hormone levels are also to be assessed.

The results of these tests must however be normal in the context of Forestier's disease.

How is Forestier's disease treated?

As the exact causes of Forestier's disease are still poorly identified, there is no specific treatment to cure it. In addition, in the majority of cases, it turns out that patients tolerate the symptoms well.

The treatments offered by the doctor are mainly symptomatic. They aim to reduce pain, reduce stiffness and improve mobility in diseased joints.

Faced with painful symptoms, it is often recommended to take analgesics (paracetamol) or nonsteroidal anti-inflammatory drugs (NSAIDs). Alternatively, there are corticosteroid injections.

RECOMMENDED FOR YOU:  Forestier disease and diet: What you need to know

In addition, to treat stiffness and improve the patient's physical abilities, movement professionals can intervene. It can be a physiotherapist, an occupational therapist or an osteopath.

For severe cases such as compression of the digestive tract, airways or spinal nerves, a surgical intervention may be needed to remove bone spurs affecting organs. This operation is called decompression surgery.

To prevent other unpleasant symptoms from being added to those ofhyperostosis vertebral, it is also necessary to treat the risk factors. To do this, the doctor prescribes a typical treatment depending on the patient's situation:

  • diabetes treatment for diabetics;
  • a weight control program for obese people;
  • treatment for hyperuricaemia.

With proper treatment, the Forestier's disease may have a good prognosis. Treatments cannot yet completely cure the disease, but they allow a normal life with less pain and difficulty in moving. To ensure better care, it is best to always consult a doctor.

References

https://arthrite.ca/a-propos-de-l-arthrite/les-types-d-arthrite-de-a-a-z/types/maladie-de-forestier-et-rotes-querol# : ~ : text=Les%20personnes%20atteintes%20de%20la, ou%20de%20fissures%20des%20vert%C3%A8bres.

https://www.concilio.com/rhumatologie-pathologies-du-rachis-maladie-de-forestier-et-rotes-querol-ou-hyperostose-vertebrale-engainante-ankylosante/

https://rheuminfo.com/fr/maladies/hyperostose-squelettique-idiopathique-diffuse/

Was this article helpful to you?

Indicate your appreciation of the article

Readers rating 4.1 / 5. Number of votes 9

If you have benefited from this article

Please share it with your loved ones

thank you for your comeback

How can we improve the article?

Back to top