Forestier disease presenting as dysphagia
Riffaud, L.; Mohr, E.; Morandi, X.; Godey, B.; Feat, S.; Brassier, G.
Presse Medicale 31(35): 1650-1652
2002
ISSN/ISBN: 0755-4982 PMID: 12448330 Document Number: 548775
Forestier's disease is characterized by hyperostosis of the anterolateral margin of the vertebral bodies. Cervical spine involvement rarely leads to dysphagia. A 76 year-old man suffered from progressive dysphagia, feeling of suffocation and left cervical pain. Clinical examination was unremarkable but cervical spine radiographies revealed large anterior osteophytes creating pharyngeal encroachment. Computed tomography showed a "double vertebral body" aspect notably in C2 and C3, compressing ahead structures. Surgical procedure consisted in resection of the anterior osteophytes. Postoperative course was uneventful and all the symptoms resolved within a few weeks. Anterior cervical spine hyperostosis in Forestier's disease can lead to dysphagia by direct pharyngeal or esophageal compression and, later on, by muscular fibrosis of the pharyngoesophageal wall in severe cases. Surgery must take the place of medical treatment in severe dysphagias with a good radioclinical correlation, to improve functional prognosis.