BMJ Case Reports 2017; doi:10.1136/bcr-2016-218630

Cervical diffuse idiopathic skeletal hyperostosis (DISH) causing oropharyngeal dysphagia

  1. Mario Naranjo
  1. Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Nellowe Candelario, candelan{at}
  • Accepted 6 March 2017
  • Published 17 March 2017


Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory condition characterised by calcification and ossification of the vertebral ligaments. It is most commonly seen to affect the thoracic and lumbar vertebrae and is usually seen among elderly men. The cause of this condition is unknown. Risk factors include male gender, obesity, diabetes and advancing age. The majority of these cases are found incidentally on imaging and patients are generally asymptomatic. Cervical DISH is less common than its thoracic and lumbar counterparts. When symptomatic, it can cause dysphagia or sometimes airway compromise. If this happens, surgical intervention should be performed. Although a rare cause of dysphagia, DISH is easily diagnosed with imaging. When identified, surgical decompression produces very good clinical outcomes.


  • Contributors NC he wrote the manuscript, proof read and approved the final manuscript for submission. KBL has helped doing the review of literature and writing the manuscript. MN helped revising the manuscript, proof read and approved it for submission.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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