Presentation
Dysphagia. Endoscopy reported extrinsic compression over the hypopharynx and proximal cervical esophagus.
Patient Data
There is marked anterior cervical osteophyte formation at C2 to T2 levels, causing compression over the proximal esophagus, in keeping with diffuse idiopathic skeletal hyperostosis (DISH).
No pathologic post-contrast enhancement is identified. No abnormal collection is seen in the region.
Straightening of the cervical spine with loss of physiologic lordosis is seen, suggesting para-spinal muscle stiffness.
Posterior disc osteophyte complex and ligamentum flavum hypertrophy at the C4/5 level result in stenosis of the spinal canal and cord compression with stenosis of the left lateral recess at this level (0.8 cm AP diameter of the spinal canal at this level).
Posterior disc osteophyte complex at T1/2 level, slightly indenting the thecal sac.
Case Discussion
The anterior cervical multi-level large osteophyte formation causes extrinsic compression over the proximal esophagus. There is no discrete mass lesion.
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