A rare presentation of diffuse idiopathic skeletal hyperostosis with progressive dysphagia and choking.

Abstract

Background: Diffuse idiopathic skeletal hyperostosis (DISH) is a rheumatological disorder characterized by the formation of spinal osteophytes due to the ossification of paravertebral ligaments and muscles, particularly involving the anterior longitudinal ligament. The disease typically manifests after the fifth decade of life and is most commonly seen in the thoracic spine. Here, we present the case of an 85-year-old female with cervical DISH who experienced dysphagia, choking, and even airway obstruction. Following anterior resection of the osteophytes, her symptoms largely resolved.

Case description: An 85-year-old female patient presented with progressive dysphagia and choking for 2 years. With the diagnosis of DISH, she underwent anterior resection of C4-C6 with subsequent marked significant improvement in symptoms.

Conclusion: Cervical DISH may cause progressive dysphagia and choking due to anterior cervical osteophyte formation. In this case, the patient showed significant clinical improvement following direct anterior resection of C4-C6 osteophytes.