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Dysphagia From Thoracic Ankylotic Spur

Michael R. Rask, MD
JAMA. 1978;240(11):1139. doi:10.1001/jama.1978.03290110037008.
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To the Editor.—  I have seen a patient with dysphagia from an ankylotic thoracic spur. The esophagus was impinged between the spur and the heart.

Report of a Case.—  An 80-year-old man has been careful about his health all his life and had been known to have ankylosing spondylitis since he was much younger. He exercises daily and takes vitamins. About three months previously he noted that one of his large vitamin capsules became lodged in his esophagus; it took a long time for the capsule to pass into his stomach. The vitamin became progressively harder to swallow. A barium swallow showed impingement of the esophagus between a huge ankylotic spur at D8-9 and the right atrium of the heart (Figure). The patient also has ankylosis in the cervical spine and matches the HLAB27 histocompatibility antigen. The patient does not wish osteophytectomy.


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