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Diffuse Idiopathic Skeletal Hyperostosis: A Case with Dysphonia, Dysphagia and Myelopathy

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Patient complains / malpractice, Unexpected drug reaction , Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Yu Soejima, Junichi Arima, Toshio Doi

Department of Orthopedic Surgery, Aso-Iizuka Hospital, Fukuoka City, Fukuoka, Japan

Am J Case Rep 2019; 20:349-353

DOI: 10.12659/AJCR.913792

Available online:

Published: 2019-03-17

BACKGROUND: Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by the ossification of soft tissues, primarily the ligaments and enthesis. Exuberant osteophyte formation of the anterior longitudinal ligament of the spine is usually found. Among the reported complications of cervical osteophyte, dysphagia is the most frequent symptom, and dysphonia is rare.
CASE REPORT: A 66-year old male was suffering from progressive dysphonia, dysphagia, and myelopathy. Anterior cervical osteophytes and ossification of the posterior longitudinal ligament (OPLL) was shown on x-ray and computed tomography (CT). He was diagnosed with DISH and the osteophytes were resected. The patient’s symptoms gradually improved.
CONCLUSIONS: DISH may induce varying symptoms and surgical intervention is a good way to relieve these symptoms. We rarely see the symptoms of dysphonia, but we should consult with other professionals, such as otolaryngologist and dietician, when treating DISH patients.

Keywords: Cervical Vertebrae, Deglutition Disorders, dysphonia, Hyperostosis, Diffuse Idiopathic Skeletal, Ossification of Posterior Longitudinal Ligament, Spinal Cord Compression