The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

A rare cause of dysphagia: compression of the esophagus by an anterior cervical osteophyte due to ankylosing spondylitis

  • Albayrak, Ilknur (Department of Physical Therapy and Rehabilitation, Beysehir Public Hospital) ;
  • Bagcaci, Sinan (Department of Physical Therapy and Rehabilitation, Selcuk University Meram Faculty of Medicine) ;
  • Salli, Ali (Department of Physical Therapy and Rehabilitation, Selcuk University Meram Faculty of Medicine) ;
  • Kucuksen, Sami (Department of Physical Therapy and Rehabilitation, Selcuk University Meram Faculty of Medicine) ;
  • Ugurlu, Hatice (Department of Physical Therapy and Rehabilitation, Selcuk University Meram Faculty of Medicine)
  • Received : 2012.02.07
  • Accepted : 2012.09.17
  • Published : 2013.09.01
⟨ Previous Next ⟩

Abstract

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatological disease affecting the axial skeleton with various extra-articular complications. Dysphagia due to a giant anterior osteophyte of the cervical spine in AS is extremely rare. We present a 48-year-old male with AS suffering from progressive dysphagia to soft foods and liquids. Esophagography showed an anterior osteophyte at C5-C6 resulting in esophageal compression. The patient refused surgical resection of the osteophyte and received conservative therapy. However, after 6 months there was no improvement in dysphagia. This case illustrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS and should be included in the diagnostic workup in early stages of the disease.

Keywords

References

  1. Sieper J, Braun J, Rudwaleit M, Boonen A, Zink A. Ankylosing spondylitis: an overview. Ann Rheum Dis 2002;61 Suppl 3:iii8-iii18. https://doi.org/10.1136/ard.61.suppl_3.iii8
  2. De Jesus-Monge WE, Cruz-Cuevas EI. Dysphagia and lung aspiration secondary to anterior cervical osteophytes: a case report and review of the literature. Ethn Dis 2008;18(2 Suppl 2):S2-137-S2-140.
  3. Miyamoto K, Sugiyama S, Hosoe H, Iinuma N, Suzuki Y, Shimizu K. Postsurgical recurrence of osteophytes causing dysphagia in patients with diffuse idiopathic skeletal hyperostosis. Eur Spine J 2009;18:1652-1658. https://doi.org/10.1007/s00586-009-1133-3
  4. Brewerton DA, Hart FD, Nicholls A, Caffrey M, James DC, Sturrock RD. Ankylosing spondylitis and HL-A 27. Lancet 1973;1:904-907.
  5. Dominguez-Lopez ML, Ortega-Ortega Y, Manriquez-Raya JC, Burgos-Vargas R, Vega-Lopez A, Garcia-Latorre E. Antibodies against recombinant heat shock proteins of 60 kDa from enterobacteria in the sera and synovial fluid of HLA-B27 positive ankylosing spondylitis patients. Clin Exp Rheumatol 2009;27:626-632.
  6. Hoh DJ, Khoueir P, Wang MY. Management of cervical deformity in ankylosing spondylitis. Neurosurg Focus 2008;24:E9.
  7. Resnick D, Niwayama G. Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). Radiology 1976;119:559- 568. https://doi.org/10.1148/119.3.559
  8. Suzuki K, Ishida Y, Ohmori K. Long term follow-up of diffuse idiopathic skeletal hyperostosis in the cervical spine: analysis of progression of ossification. Neuroradiology 1991;33:427-431. https://doi.org/10.1007/BF00598618
  9. Akhtar S, O'Flynn PE, Kelly A, Valentine PM. The management of dysphasia in skeletal hyperostosis. J Laryngol Otol 2000;114:154-157.
  10. Forestier J, Rotes-Querol J. Senile ankylosing hyperostosis of the spine. Ann Rheum Dis 1950;9:321-330. https://doi.org/10.1136/ard.9.4.321
  11. Uppal S, Wheatley AH. Transpharyngeal approach for the treatment of dysphagia due to Forestier's disease. J Laryngol Otol 1999;113:366-368.
  12. McCafferty RR, Harrison MJ, Tamas LB, Larkins MV. Ossification of the anterior longitudinal ligament and Forestier's disease: an analysis of seven cases. J Neurosurg 1995;83:13-17. https://doi.org/10.3171/jns.1995.83.1.0013
  13. Aydin E, Akdogan V, Akkuzu B, Kirbas I, Ozgirgin ON. Six cases of Forestier syndrome, a rare cause of dysphagia. Acta Otolaryngol 2006;126:775-778. https://doi.org/10.1080/00016480500504192

Cited by

  1. Dysphagia Related to Esophagus Compression by Anterior Cervical Ossification in a Patient with Ankylosing Spondylitis vol.42, pp.10, 2015, https://doi.org/10.3899/jrheum.150449
  2. A Case of a Paracardial Osteophyte Causing Atrial Compression vol.2016, pp.None, 2013, https://doi.org/10.1155/2016/4325830
  3. Prospective Multicenter Assessment of Early Complication Rates Associated With Adult Cervical Deformity Surgery in 78 Patients vol.79, pp.3, 2013, https://doi.org/10.1227/neu.0000000000001129
  4. DISFAGIA SECUNDÁRIA A OSTEÓFITOS EM COLUNA CERVICAL: RELATO DE CASO vol.57, pp.suppl1, 2013, https://doi.org/10.1016/j.rbr.2017.06.081
  5. Timing for surgical intervention in DISHphagia vol.9, pp.4, 2013, https://doi.org/10.4103/jcvjs.jcvjs_83_18
  6. Cervical osteophytosis and spine posture: contribution to swallow disorders and symptoms vol.26, pp.6, 2013, https://doi.org/10.1097/moo.0000000000000488
  7. Surgical treatment of anterior cervical osteophytes causing dysphagia vol.27, pp.2, 2019, https://doi.org/10.1177/2309499019837424
  8. Dysphagie bei Erkrankungen der Halswirbelsäule vol.67, pp.10, 2013, https://doi.org/10.1007/s00106-019-00738-7
  9. Dysphagia in a patient with ankylosing spondylitis: A case report vol.9, pp.7, 2021, https://doi.org/10.12998/wjcc.v9.i7.1639
  10. Factors which predict adverse events following surgery in adults with cervical spinal deformity vol.b103, pp.4, 2013, https://doi.org/10.1302/0301-620x.103b4.bjj-2020-0845.r2