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Woman with dysphagia
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Woman with dysphagia - December 2, 2004 4:22:00 AM
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chiroortho
Posts: 655
Joined: February 18, 2004
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What do you see here?
< Message edited by David Adamczyk -- July 6, 2007 7:51:56 AM >
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Greg Priest, DC, DABCO
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Re: Woman with dysphagia - December 2, 2004 4:25:00 AM
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FLAOrthoPT
Posts: 1011
Joined: May 8, 2004
From: West Palm Beach
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looks almost like natural anterior fused c-spine..or is that calcification in her esophagus or trachea? looks strange for sure-
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Re: Woman with dysphagia - December 2, 2004 4:32:00 AM
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chiroortho
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What do you think? You're on the right track. Remember your anatomy.
Would you consider this to be degenerative in nature (notice the normal disc heights)?
I'll tell you what it's not: calcification within the esophagus or trachea. Good guess though.
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Greg Priest, DC, DABCO
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Re: Woman with dysphagia - December 2, 2004 6:22:00 AM
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tr6454
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Greg,
? diffuse idopathic skeletal hyperostosis (DISH)
Terry
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Terry
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Re: Woman with dysphagia - December 2, 2004 7:12:00 AM
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chiroortho
Posts: 655
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Terry,
Exactly right! From the University of Washington Radiology Teaching File: [QUOTE]Diffuse idiopathic skeletal hyperostosis syndrome (DISH)
Findings
>Flowing ossification of the anterior longitudinal ligament, involving at least 4 adjacent disk spaces
>Lack of intervertebral disk space narrowing
Brief Discussion
DISH syndrome is an idiopathic disorder, and therefore, by definition, a diagnosis of exclusion. In general, one must exclude 3 other entities that can commonly present with fairly large "phytes" in the spine:
1. ankylosing spondylitis
2. degenerative nuclear disease
3. degenerative annular disease[/QUOTE]This is a perennial favorite on the Florida Board of Chiropractic Medicine examination.
_____________________________
Greg Priest, DC, DABCO
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Re: Woman with dysphagia - December 2, 2004 7:24:00 AM
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jma
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From: NY
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Wow!,
Would have never guessed this but the ossification was very clear. Definitely, one to remember if I ever see C-spine radiographs.
JMA
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Re: Woman with dysphagia - December 2, 2004 1:34:00 PM
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FLAOrthoPT
Posts: 1011
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From: West Palm Beach
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bizarre..yeah knew it looked fused anteriorly but never really saw that before..cool, for me, not for her
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Re: Woman with dysphagia - December 2, 2004 5:05:00 PM
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bonmar
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From: Boston, MA
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Great pics and post but I am curious if dysphagia was this patients only symptom? Also, please clarify why DISH would cause dysphagia? Elevated hyoid?
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Re: Woman with dysphagia - December 2, 2004 5:14:00 PM
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chiroortho
Posts: 655
Joined: February 18, 2004
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encroachment upon the esophagus. That's why I said earlier to remember your anatomy. Now you'll look at the picture and go 'of course'.
Don't know her other symptoms, but since you asked, DISH is frequently asymptomatic in and of itself. It's essentially an autofusion, and is found incidentally, eg a patient comes in after an MVA, has some films and voila!
_____________________________
Greg Priest, DC, DABCO
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