Extrinsic airway compression: an unusual presentation of thoracic vertebral osteophytes from osteoarthritis

Extrinsic airway compression secondary to vertebral osteophytes is a rare clinical entity. We report a case of an elderly patient presenting with pneumonia where a subsequent chest CT scan showed right main bronchus compression caused by lower thoracic vertebral osteoarthritis-related osteophytes. There were additional incidental findings of sclerotic skeletal lesions prompting a new diagnosis of metastatic prostate cancer. The pneumonia improved with antibiotic therapy. Interventional management of airway compression was not pursued in this patient given his poor functional state and advanced metastatic malignancy. The patient was later readmitted with recurrent pneumonia as expected. Clinicians should be aware of this rare entity as a potential cause of airway compression identifiable on CT chest.