Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by, among other things, spinal and extraspinal manifestations. Two studies on the prevalence and clinical significance of hyperostotic spurs and ectopic ossifications in the pelvic area are presented. Spinal DISH seems to be a risk factor for the development of ectopic ossification, particularly in the postoperative course after total hip arthroplasty. Pain and reduced range of motion, however, are not obligatory consequences of these phenomena.