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Cervical diffuse idiopathic skeletal hyperostosis (DISH) causing oropharyngeal dysphagia
Nellowe Candelario1, Kevin Bryan Lo1, Mario Naranjo1
1Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
BMJ Case Reports
|March 19, 2017
Summary
Diffuse idiopathic skeletal hyperostosis (DISH) causes vertebral ligament calcification, primarily in older men. While often asymptomatic, cervical DISH can lead to swallowing or breathing issues, treatable with surgery.
Area of Science:
- Rheumatology
- Orthopedics
- Radiology
Background:
- Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory spinal condition.
- Characterized by calcification and ossification of vertebral ligaments, it predominantly affects the thoracic and lumbar spine.
- The etiology of DISH remains unknown, with risk factors including male gender, obesity, diabetes, and advanced age.
Observation:
- DISH is frequently discovered incidentally on imaging studies.
- Most patients with DISH are asymptomatic.
- Cervical DISH, though less common, can present with significant symptoms.
Findings:
- Symptomatic cervical DISH may manifest as dysphagia (difficulty swallowing) or airway compromise.
- Diagnosis of DISH is readily achieved through medical imaging.
- Surgical intervention is indicated for symptomatic cervical DISH.
Implications:
- Surgical decompression for symptomatic cervical DISH yields favorable clinical outcomes.
- DISH is a recognized, albeit rare, cause of dysphagia.
- Early diagnosis via imaging facilitates effective management and improved patient prognosis.
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