Dysphagia in an elderly male: A rare cause

A 65-year-old male patient who was known to have type 2 diabetes mellitus and was receiving treatment for the same for the last 20 years presented with pain and stiffness of neck with limited mobility of cervical spine, and progressive dysphagia of 1 month duration. His glycaemic control was good and he did not have evidence of diabetic nephropathy. Radiograph of the cervical spine showed florid, anterior flowing of bridging osteophytes from C3-C6 vertebra (Figures 1A and 1B) impinging on the oesophagus with preservation of disc spaces. There was no evidence of apophyseal joint degeneration or sacroiliac inflammatory changes. The patient was diagnosed to have diffuse idiopathic skeletal hyperostosis (DISH) as per the classification criteria defined by Resnick and Niwayama.1,2