Case study 60 - DISH-phagia Diffuse idiopathic skeletal hyperostosis (DISH) is a rheumatologic disease which can cause cervical osteophytes and lead to otolaryngological symptoms such as difficulty in swallowing, difficulty in breathing and loss of weight. Primarily involved structure is the anterior longitudinal ligament, ossification and calcification of which result in osteophyte formation. Dysphagia due to DISH involving the cervical spine is relatively unusual (17% of patients with DISH). D