Progressive dysphagia secondary to cervical osteophytosis due to diffuse idiopathic skeletal hyperostosis (DISH)

Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory systemic disease characterised by ossification of ligaments and entheses. Although it is usually asymptomatic, in its cervical localisation it can cause dysphagia secondary to oesophageal compression or functional limitation due to ankylosis. We present the case of a 58-year-old male with progressive dysphagia of three years' evolution, with an EAT-10 score of 34/40. Surgical resection of the impressive osteophyte formation was performed by an anterior cervical spine approach and precision drilling. Within a few weeks, there was a reported progressive improvement and complete resolution of the symptoms. The pathophysiological mechanisms involved and current recommendations on surgical indications, prognosis and follow-up are discussed. Awareness of this therapeutic option is paramount in non-surgical specialties, and interdisciplinary discussion is recommended.