Diffuse idiopathic skeletal hyperostosis as a cause of dysphagia ina young patient with metabolic syndrome

A 42-year-old male patient was admitted to our clinic with neck pain, stiffness, limited range of motion in the neck, and dysphagia upon eating solid foods. The pain had started about 5 years previously and increased over time. The patient had no history of trauma to the neck. He had a history of type 2 diabetes mellitus (for 3 years), hypertension (for 10 years), chronic renal failure, and dyslipidemia. The patient was morbidly obese (body mass index: 41). He had experienced frequent infections of the upper respiratory tract during recent years. Motor, sensory, and other neurologic examinations showed no signs of cervical radiculopathy. Range of motion in the neck was limited in all directions, and widespread cervical paravertebral spasm and tenderness were detected. Radiologic investigations showed contiguous vertebrae, bridging osteophytes (Figure 1). Findings of sacroiliac joint radiography were normal.