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Diffuse idiopathic skeletal hyperostosis

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

Dysphagia, his pharyngoscope revealed posterior pharyngeal swelling.

Patient Data

Age: 80 year old
Gender: Male

Florid, flowing ossification is noted along the anterior aspects of the cervical vertebrae merging with bridging anterior osteophytes that encroach upon the oropharynx anteriorly.

C4/5, C5/6 & C6/7 intra-discal calcfications.

Subtle posterior longitudinal ligament calcification.

Nuchal ligament calcification.

Left maxillary sinusitis with internal material of increased density (that could represent fungal infection) (incidental finding).

Annotated image

Florid, flowing ossification is noted along the anterior aspects of the cervical vertebrae merging with bridging anterior osteophytes that encroach upon the oropharynx anteriorly (mainly at the left side). (Circles)

Case Discussion

Diffuse idiopathic skeletal hyperostosis (DISH) also known as senile ankylosing spondyliyis.

Patients with DISH may rarely present with "Dysphagia" as in this case.

 

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