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      Diffuse Idiopathic Skeletal Hyperostosis Causing Progressive Dysphagia: A Case Report and Review

      case-report
      1 , 2 , 3 ,
      Case Reports in Radiology
      Hindawi

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          Abstract

          Background

          Diffuse idiopathic skeletal hyperostosis (DISH) is a rare noninflammatory disorder impacting spinal longitudinal ligament and enthesis. The majority of DISH cases are asymptomatic or have few manifestations. Manifestations include neck pain and stiffness, stridor, breathing disturbances, and dysphagia. Case Presentation. A mid-aged man with progressive dysphagia to solid food was admitted to Loghman Hakim Hospital. In cervical X-ray, a huge ossification in the anterior longitudinal ligament was evident. Eventually, he was diagnosed with DISH. Because of coronary artery disease, conservative treatment was considered for him.

          Conclusion

          DISH is a rare disorder usually asymptomatic. In this case report, we present a DISH case with progressive dysphagia to solid foods.

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          Most cited references24

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          Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH).

          The vertebral involvement of DISH is described from an evaluation of 215 cadaveric spines and 100 patients with the disease. Radiographic features include linear new bone formation along the anterolateral aspect of the thoracic spine, a bumpy contour, subjacent radiolucency, and irregular and pointed bony excrescences at the superior and inferior vertebral margins in the cervical and lumbar regions. Pathologic features include focal and diffuse calcification and ossification in the anterior longitudinal ligament, paraspinal connective tissue, and annulus fibrosis, degeneration in the peripheral annulus fibrosis fibers, L-T-, and Y-shaped anterolateral extensions of fibrous tissue, hypervascularity, chronic inflammatory cellular infiltration, and periosteal new bone formation on the anterior surface of the vertebral bodies.
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            Senile ankylosing hyperostosis of the spine.

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              Diffuse idiopathic skeletal hyperostosis (DISH): Forestier's disease with extraspinal manifestations.

              The extraspinal manifestations of Forestier's disease are described in 21 consecutive cases; diffuse idiopathic skeletal hyperostosis (DISH) is suggested as a more appropriate description of this ossifying diathesis. Characteristic roentgen abnormalities of the spine were present in all individuals and associated with significant axial clinical complaints. In extraspinal locations, hyperostosis at ligament attachments usually occurs in the pelvis, calcaneus, tarsal bones, ulnar olecranon and patella, and is occasionally associated with clinical signs and symptoms requiring surgery. The radiographic appearance in the peripheral skeleton is frequently distinctive and allows the radiologist to suggest the correct diagnosis, even in the absence of axial radiographs.
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                Author and article information

                Contributors
                Journal
                Case Rep Radiol
                Case Rep Radiol
                CRIRA
                Case Reports in Radiology
                Hindawi
                2090-6862
                2090-6870
                2023
                25 September 2023
                : 2023
                : 8853575
                Affiliations
                1Department of Otorhinolaryngology, Loghman Hakim Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                2Hearing Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                3Department of Radiology, Loghman Hakim Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                Author notes

                Academic Editor: Daniel P. Link

                Author information
                https://orcid.org/0000-0003-4609-3460
                https://orcid.org/0000-0002-6443-9448
                https://orcid.org/0000-0003-4593-124X
                Article
                10.1155/2023/8853575
                10545457
                37790679
                52dd108a-b9e5-450a-add2-e888eeead806
                Copyright © 2023 Farzin Davoodi et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 April 2023
                : 8 June 2023
                : 7 August 2023
                Categories
                Case Report

                Radiology & Imaging
                Radiology & Imaging

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