Diffuse idiopathic skeletal hyperostosis (DISH) with tracheal stenosis
Presentation
Dyspnea and dysphagia.
Patient Data
Decreased AP diameter of the cervical segment of the trachea reaching 60% stenosis. The posterior tracheal wall is moderately indented and anteriorly splayed by the effect of hypertrophied anterior osteophytes of the cervical spine.
Contiguous multilevel spondylodegenerative changes of the cervical spine with evident flowing anterior osteophytes compressing and anteriorly displacing the trachea and esophagus.
Case Discussion
This study shows extrinsic tracheal and esophageal compression by cervical spondylosis with marked anterior osteophytes and syndesmophytes affecting all cervical vertebrae consistent with diffuse idiopathic skeletal hyperostosis (DISH). This unusual etiology differs from tracheomalacia which decreased AP tracheal diameter in affecting the cervical segment instead of the thoracic segment and obvious extrinsic compression.
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