FORESTIERS-DISEASE REVEALED BY DYSPHAGIA - A CASE-REPORT

A 74-year-old man presented with a several year history of dysphagia a nd dysphonia. X-ray examination showed prevertebral ossification, from C2-C3 to C3-C4, associated with a calcification of the anterior longi tudinal ligament. The same abnormalities were present in the thoracolu mbar spine. There was no hypertrophy nor ankylosis of the articular jo ints or the sacroiliac articles, and no biological abnormalities. Thes e characteristics are typical of Forestier's disease also named ''diff use idiopathic skeletal hyperostosis (DISH)''. Because of the conseque nces of dysphagia, an operation was carried out with a good result at two months. Symptomatic forms of Forestier's disease are uncommon, but in some cases, surgery is indicated because of the importance of dysp hagia and respiratory disturbances. The role of direct compression of the esophagus or the pharynx by the ossification is possible but an as sociated inflammatory reaction cannot be excluded.