ABSTRACT
Diffuse idiopathic skeletal hyperostosis is a non-inflammatory disease characterized by ossification and calcification in soft tissues, such as enthesis and joint capsules. The thoracic vertebra is often affected; however, cervical vertebra involvement can also be seen. Diagnosis is made by observing ossifications in the anterior surface of the four vertebrae and excluding spinal degenerative and inflammatory diseases. Pain and movement limitation is frequently observed in cervical vertebra involvement, but symptoms, such as dysphagia, hoarseness, and snoring, may also occur. This study aimed to present a 69-year-old male patient with pain in the neck and back, movement limitations, and swallowing difficulties, mostly with solid foods. The cervical imaging of the patient revealed anterior ossifications that compress the esophagus and posterior ossifications without myelomalacia. Surgery was recommended to the patient for his progressive dysphagia but was refused. Partial improvement was achieved in the patient’s complaints with exercise and swallowing training in pain, movement limitation, and swallowing difficulties.
Keywords:
Neck pain, dysphagia, Forestier disease
References
1Weinfeld RM, Olson PN, Maki DD, Griffiths HJ. The prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in two large American Midwest metropolitan hospital populations. Skeletal Radiol 1997;26:222-5.
2Kuperus JS, Mohamed Hoesein FAA, de Jong PA, Verlaan JJ. Diffuse idiopathic skeletal hyperostosis: Etiology and clinical relevance. Best Pract Res Clin Rheumatol 2020;34:101527.
3Goico-Alburquerque A, Zulfiqar B, Antoine R, Samee M. Diffuse Idiopathic Skeletal Hyperostosis: Persistent Sore Throat and Dysphagia in an Elderly Smoker Male. Case Rep Med 2017;2017:2567672.
4Ghammam M, Houas J, Bellakhdher M, Abdelkefi M. Dysphagia revealing diffuse idiopathic skeletal hyperostosis: report of two cases and literature review. Pan Afr Med J 2019;32:189.
5Cammisa M, De Serio A, Guglielmi G. Diffuse idiopathic skeletal hyperostosis. Eur J Radiol 1998;27 Suppl 1:S7-11.
6Castellano DM, Sinacori JT, Karakla DW. Stridor and dysphagia in diffuse idiopathic skeletal hyperostosis (DISH). Laryngoscope 2006;116:341-4.
7Seidler TO, Pèrez Alvarez JC, Wonneberger K, Hacki T. Dysphagia caused by ventral osteophytes of the cervical spine: clinical and radiographic findings. Eur Arch Otorhinolaryngol 2009;266:285-91.
8Resnick D, Niwayama G. Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). Radiology 1976;119:559-68.
9Holgate RL, Steyn M. Diffuse idiopathic skeletal hyperostosis: Diagnostic, clinical, and paleopathological considerations. Clin Anat 2016;29:870-7.
10Kuperus JS, de Gendt EEA, Oner FC, de Jong PA, Buckens SCFM, van der Merwe AE, et al. Classification criteria for diffuse idiopathic skeletal hyperostosis: a lack of consensus. Rheumatology (Oxford) 2017;56:1123-34.
11Mader R, Verlaan JJ, Buskila D. Diffuse idiopathic skeletal hyperostosis: clinical features and pathogenic mechanisms. Nat Rev Rheumatol 2013;9:741-50.
12Smythe H, Littlejohn G. Diffuse idiopathic skeletal hyperostosis. In: Klippel JH, PA D, editors. Rheumatology. 2nd ed. London: Mosby; 1998. p. 1-6.
13Pulcherio JO, Velasco CM, Machado RS, Souza WN, Menezes DR. Forestier’s disease and its implications in otolaryngology: literature review. Braz J Otorhinolaryngol 2014;80:161-6.
14Verlaan JJ, Boswijk PF, de Ru JA, Dhert WJ, Oner FC. Diffuse idiopathic skeletal hyperostosis of the cervical spine: an underestimated cause of dysphagia and airway obstruction. Spine J 2011;11:1058-67.
15Yoshioka K, Murakami H, Demura S, Kato S, Yonezawa N, Takahashi N, et al. Surgical Treatment for Cervical Diffuse Idiopathic Skeletal Hyperostosis as a Cause of Dysphagia. Spine Surg Relat Res 2018;2:197-201.
16Fogel GR, McDonnell MF. Surgical treatment of dysphagia after anterior cervical interbody fusion. Spine J 2005;5:140-4.
