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[吞咽困难的罕见病因:Forestier病]

[A rare cause of dysphagia: Forestier's disease].

作者信息

Kara Ozlem, Ozmen Cihan Akgül, Yildirim Baylan Müzeyyen, Nazaroğlu Hasan

机构信息

Department of Radiology, Medicine Faculty of Dicle University, Diyarbakir, Turkey.

出版信息

Kulak Burun Bogaz Ihtis Derg. 2010 May-Jun;20(3):150-3.

Abstract

Forestier's disease is a rare rheumatologic disease characterized by ossification in various spinal and extraspinal ligaments especially the anterior longitudinal ligament. The hypertrophic bone proliferations seen in cervical involvement may be so extensive causing dysphagia. We present Forestier's disease as a rare cause of dysphagia with clinical and radiological findings. An 80-year-old male was admitted for 2-3 months' increasing dysphagia and sore throat. Examination of the oropharynx revealed a 3 cm painless, hard swelling posterior to the epiglottis. A large area of ossification was detected in the anterior portion of the C2-7 vertebrae on lateral cervical roentgenogram. Neck computed tomography revealed bridging hyperosseous changes in the anterior longitudinal ligament between the C2-7 vertebrae and narrowing of the pharyngeal passage. A lesion with similar intensity to adjacent vertebrae and heterogeneous appearance lying along the anterior longitudinal ligament was seen on cervical magnetic resonance imaging. We interpreted the large osseous lesion to be an ossified anterior longitudinal ligament causing dysphagia, and a diagnosis of Forestier's disease was based on these findings. Forestier's disease must be kept in mind as a rare etiology in the differential diagnosis of dysphagia.

摘要

福里斯特尔病是一种罕见的风湿性疾病,其特征是在各种脊柱和脊柱外韧带,尤其是前纵韧带中出现骨化。颈椎受累时可见的肥厚性骨增生可能非常广泛,导致吞咽困难。我们通过临床和影像学表现,将福里斯特尔病作为吞咽困难的罕见病因进行介绍。一名80岁男性因吞咽困难和喉咙痛加重2至3个月入院。口咽检查发现会厌后方有一个3厘米大小、无痛的硬性肿块。颈椎侧位X线片显示C2至C7椎体前部有大面积骨化。颈部计算机断层扫描显示C2至C7椎体之间的前纵韧带存在桥接性骨质增生改变以及咽部通道变窄。颈椎磁共振成像显示沿前纵韧带出现一个与相邻椎体强度相似且外观不均匀的病变。我们将这个大的骨性病变解释为导致吞咽困难的骨化前纵韧带,并基于这些发现诊断为福里斯特尔病。在吞咽困难的鉴别诊断中,必须将福里斯特尔病视为一种罕见病因。

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