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Journal Information
Vol. 71. Issue 2.
Pages 78-82 (March - April 2020)
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Vol. 71. Issue 2.
Pages 78-82 (March - April 2020)
Original article
Incidence of Diffuse Idiopathic Skeletal Hyperostosis From a Model of Dysphagia
Incidencia de la hiperostosis esquelética difusa idiopática sobre un modelo clínico de disfagia
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Francisco Javier García Callejo
Corresponding author
jgarciacall@hotmail.com

Corresponding author.
, Natsuki Oishi, Isabel López Sánchez, Beatriz Pallarés Martí, Andrea Rubio Fernández, María José Gómez Gómez
Servicio de ORL, Centro de Salud Integrado de Torrente, Consorcio-Hospital General Universitario de Valencia, Spain
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Abstract
Objective

To relate symptoms of dysphagia to Forestier–Rotes Querol disease or diffuse idiopathic skeletal hyperostosis (DISH), a disorder due to ossification in the anterior longitudinal ligament and calcifications in other entheses.

Patients and methods

Review of clinical and radiological findings in 455 outpatients attended at our Center with dysphagia, for 5 years, referred from dental, trauma, neurological or primary health care. A diagnosis of DISH was established using Resnick's criteria.

Results

We detected 51 cases with dysphagia consistent with DISH diagnostic criteria – 11.2% of subjects suffering this symptom – out of 32544 outpatients attended. An incidence of 7:100000 inhabitants per year was observed. Two cases showed significant improvement after removing the new bone in the spine.

Conclusions

DISH is an ankylosing ossification between the joints, frequently systemic but showing no clinical symptoms. When symptoms manifest, neck movements and upper airways are involved, mainly dysphagia. A few cases need surgery to relieve the calcification processes.

Keywords:
Forestier's disease
Diffuse idiopathic skeletal hyperostosis
Dysphagia
Epidemiology
Diagnosis
Incidence
Resumen
Objetivo

Relacionar la clínica de disfagia con la enfermedad de Forestier-Rotes-Querol o hiperostosis esquelética difusa idiopática (HEDI), desorden por osificación del ligamento cervical anterior común y calcificaciones en otras articulaciones.

Pacientes y métodos

Revisión del historial clínico-radiológico de 455 pacientes que en 5 años consultaron en nuestro centro por disfagia, remitidos desde Atención Primaria o diferentes especialidades. El diagnóstico de HEDI se estableció en función de los criterios descritos por Resnick.

Resultados

Sobre un volumen total de 32.544 pacientes atendidos, el 1,4% consultó por disfagia alta. En 51 casos con esta sintomatología—el 11,2% de los sujetos—pudieron verificarse datos congruentes con los hallazgos radiológicos diagnósticos de HEDI. La incidencia observada fue de 7:100.000 habitantes-año. Dos casos con disfagia severa mejoraron con la retirada del hueso cervical neoformado.

Conclusiones

La HEDI supone una osificación interarticular anquilosante habitualmente sistémica pero asintomática. Al manifestarse, distorsiona principalmente las funciones de cuello y vías altas, generando sobre todo disfagia. Unos pocos casos requieren cirugía liberadora de estas calcificaciones.

Palabras clave:
Enfermedad de Forestier
Hiperostosis esquelética difusa idiopática
Disfagia
Epidemiología
Diagnóstico
Incidencia

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