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Diffuse idiopathic skeletal hyperostosis: a case of dysphagia
Trevor H Foshang1, Michael A Mestan, Lisa J Riggs
1Diagnostic Imaging, Parker College of Chiropractic, Dallas, Tex. 75229-5668, USA.
Journal of Manipulative and Physiological Therapeutics
|March 19, 2002
Summary
Diffuse idiopathic skeletal hyperostosis (DISH) can cause dysphagia due to spinal overgrowths. This case highlights conservative management for swallowing difficulties in DISH patients.
Area of Science:
- Orthopedics
- Gastroenterology
- Radiology
Background:
- Diffuse idiopathic skeletal hyperostosis (DISH) is a common condition characterized by flowing hyperostoses along the spine.
- Dysphagia, or difficulty swallowing, is an uncommon but significant complication of DISH.
Observation:
- A 63-year-old male presented with dysphagia following a fall.
- Radiographs showed significant anterior cervical hyperostoses (C3-6).
- CT and modified barium swallow studies provided detailed anatomical and functional swallowing information.
Findings:
- The patient's dysphagia was successfully managed with conservative, compensatory strategies by a speech and language pathologist over two weeks.
- Diet modification was recommended for ongoing management.
Implications:
- Enlarged spinal hyperostoses in DISH can directly compress the pharynx/esophagus or cause indirect swallowing issues.
- Conservative management is the first-line treatment for DISH-associated dysphagia.
- Surgical intervention is reserved for refractory cases.