Diffuse idiopathic skeletal hyperostosis causing dysphagia in a young patient

Area of Science:

• Orthopedics
• Gastroenterology
• Otolaryngology

Background:

• Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by flowing ossification of spinal ligaments, predominantly affecting older males.
• DISH is an under-diagnosed condition and an uncommon cause of dysphagia (difficulty swallowing) and dysphonia (voice impairment).
• This case report addresses a younger male patient presenting with symptoms suggestive of gastroesophageal reflux, which were initially unresponsive to standard treatment.

Purpose of the Study:

• To report a case of dysphagia and dysphonia caused by cervical spine osteophytes secondary to DISH.
• To emphasize the importance of considering DISH in the differential diagnosis of unexplained swallowing and voice disorders.
• To illustrate the successful management of DISH-related compressive symptoms through surgical intervention.

Main Methods:

• A case study of a 45-year-old male with a three-year history of dysphonia and three-month history of dysphagia.
• Diagnostic workup included endoscopy to rule out esophageal pathology and cervical spine radiography.
• Radiographic findings revealed significant anterior longitudinal ligament ossification and large osteophytes from C3 to C6, consistent with DISH.

Main Results:

• Cervical spine radiographs confirmed DISH with prominent osteophytes causing esophageal and upper airway compression.
• Surgical resection of the cervical osteophytes was performed.
• Complete resolution of dysphagia and dysphonia symptoms was observed post-operatively.

Conclusions:

• DISH should be considered in the differential diagnosis of patients presenting with dysphagia and dysphonia, even in younger individuals.
• Cervical osteophyte resection is an effective treatment for relieving compressive symptoms associated with DISH.
• Early recognition and appropriate management of DISH can significantly improve patient outcomes and quality of life.