Forestier’s disease: a cause of dysphagia to recall

A 68-year-old man diagnosed with Chagas disease, hypertension and type 2 diabetes mellitus was followed up at a quarterly hospital in the specialties of otolaryngology and gastroenterology because of a chronic clinical feature of dysphagia and odynophagia for solid foods, and a non-confirmed diagnosis hypothesis of chagasic megaesophagus. During complementary investigation he was submitted to lateral simple cervical radiograph that revealed an extrinsic compression of the laryngeal esophagus secondary to exuberant osteophyte in C3-C4 level. Radiography showed involvement of adjacent levels (C2-C3, C4-C5 and C5-C6), ossification of anterior longitudinal ligament and preservation of disc spaces height. Such findings, along with the absence of radiologic compromising of sacroiliac joints, correspond to Resnick criteria (1) found in the diffuse idiopathic skeletal hyperostosis (DISH) described by J. Forestier in 1950. Lateral cervical X-ray and T2-weighted sagittal magnetic resonance. We observed an extensive calcification in front of vertebral bodies of C2 to C6 in topography of anterior longitudinal ligament. Esophagus and airways present a posterior compromising, which determine a stenosed segment that difficult orotracheal intubation at time of surgical procedure