Dysphagia due to DISH-related anterior osteophytes: DISHphagia!!
نویسندگان
چکیده
Kaur J, Virk JS. BMJ Case Rep 2017. doi:10.1136/bcr-2017-222512 Description Anterior cervical osteophytes are commonly associated with degenerative spine in elderly people. The complications that arise due to the mechanical compression of cervical osteophytes are dysphagia, dysphonia and dyspnoea. The usual causes are osteoarthritis, ankylosing spondylitis and diffuse idiopathic spinal hyperostosis (DISH). Other causes are trauma, acromegaly, ochronosis, fluorosis and hypoparathyroidism. Surgical resection of osteophytes results in excellent relief of symptoms, but patients have a tendency for recurrence of osteophytes. We present here a case of dysphagia and dysphonia due to osteophyte recurrence in a postsurgical case of DISH. A 63-year-old man was admitted with progressive dysphagia, hoarseness of voice and neck pain for 3 months. His history began with neck and right arm pain 2 years back for which he consulted a spine surgeon, where he was diagnosed with C5–C6 herniated cervical disc causing root compression because of underlying DISH. His chief complaints were severe neck pain with radiation to lateral aspect of his right arm. Patient gave no history of hand clumsiness or gait imbalance. On neurological examination, patient was having no motor or sensory deficit with normal deep tendon reflexes. His plantar reflex was flexor. Radiographs, CT and MRI of the cervical spine were subsequently conducted. MRI reported a final impression of cervical spondylosis, disco-osteophytic bulge with paracentral disc protrusion at C5–C6 level causing significant compression of the cord with myelomalacia and focal canal stenosis at this level. An overall picture of DISH was also appreciated. Following this, he underwent C5–C6 anterior cervical discectomy and fusion. Anterior osteophytes at C3–C4 level were also noted in imaging but their size was small and considered insignificant to the patient’s symptoms with which the patient had presented to us. Thus, anterior osteophytes at C3–C4 level were Dysphagia due to DISH-related anterior osteophytes: DISHphagia!! Jaslovleen Kaur, Jagandeep Singh Virk Images in...
منابع مشابه
Dysphagia Due to Anterior Cervical Spine Osteophyte: A Case Report
Introduction: Degenerative changes of the cervical spine are more common in elderly, but anterior cervical osteophytes that cause problems in swallowing are rare. The most common cause of this problem is DISH disease (diffuse idiopathic skeletal hyperostosis). Trauma is also suggested as a potential cause in osteophyte formation. Case Report: We report a rare case of anterior cervical osteop...
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INTRODUCTION Two of the most common causes of anterior cervical bony outgrowths are diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS). These osteophytes have been associated with serious complications. The objective of this case report is to highlight how commonly occurring anterior cervical osteophytes may become an uncommon cause for life-threatening dysphagia an...
متن کاملProgressive dysphagia and neck pain due to diffuse idiopathic skeletal hyperostosis of the cervical spine: a case report and literature review
Diffuse idiopathic skeletal hyperostosis (DISH) is considered an underdiagnosed and mostly asymptomatic nonprimary osteoarthritis. The etiology of DISH remains unknown and the validated diagnostic criteria are absent. This condition is still recognized radiologically only. Rarely, large projecting anterior osteophytes result in esophageal impingement and distortion leading to dysphagia. We repo...
متن کاملDysphagia due to diffuse idiopathic skeletal hyperostosis of the cervical spine.
Diffuse idiopathic skeletal hyperostosis (DISH) or Forestier's disease is a common disorder of unknown etiology that is characterized by ossification of the anterior longitudinal ligament of the spine and various extra-spinal ligaments. We present the case of a 54-year-old woman with progressive dysphagia due to DISH of the cervical spine, which is a relatively rare pathology in neurosurgical p...
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ورودعنوان ژورنال:
- BMJ case reports
دوره 2017 شماره
صفحات -
تاریخ انتشار 2017