Ankylosing Spondylitis Presenting Dysphagia as a Chief Complaint : A case report.

, Kim, In Gyu; , Lee, Min Kyung; , Han, Jae Young; , Choi, In Sung; , Kim, Jae Hyung; , Lee, Sam Gyu

Case Report

Journal of the Korean Academy of Rehabilitation Medicine 2009;33(4):489-492.

Kim, In Gyu , Lee, Min Kyung , Han, Jae Young , Choi, In Sung , Kim, Jae Hyung , Lee, Sam Gyu

Department of Physical and Rehabilitation Medicine, Research Institute of Medical Sciences, Chonnam National University Medical School, Korea. LEE9299@hitel.net

연하곤란을 주소로 한 강직성 척추염-증례 보고-

김인규, 이민경, 한재영, 최인성, 김재형, 이삼규

전남대학교 의과대학 재활의학교실 및 의과학 연구소

Abstract

We report a patient with ankylosing spondylitis presenting dysphagia as a chief complaint. A 43-year-old man complained of swallowing difficulty persisted for a year. Laryngoscopy revealed bilateral arytenoid swelling. Videofluoroscopic swallowing study (VFSS) revealed penetration and aspiration of liquid, food residue in pyriform sinuses, multiple swallowing and passage disturbance of food. C-reactive protein and erythrocyte sedimentation rate were elevated. On physical examination, neck stiffness and limitation of motion of whole spine were shown. Simple radiography of spine and sacroiliac joints displayed cervical osteophyte, bamboo spine and bilateral sacroilitis. Bath ankylosing spondylitis disease activity index was 6.3 points. He was diagnosed as severe active ankylosing spondylitis. After the conservative treatment, range of motion of whole spine increased and dysphagia improved on follow-up VFSS. Dysphagia in ankylosing spondylitis may be attributed to postural changes due to limitation of cervical motion and inflammation of soft tissue. (J Korean Acad Rehab Med 2009; 33: 489-492)

Key Words: Ankylosing spondylitis, Dysphagia, Posture, Inflammation