A 79-year-old man presented with painless dysphagia. Results of an oesophagogastroduodenoscopy were unremarkable. A dynamic videofluoroscopic examination was diagnostic, revealing hypertrophic cervical osteophytes indenting the hypopharynx and oesophagus. The osteophytes were also seen on a lateral cervical spine radiograph (Box). The dysphagia responded to dietary modification.

Although cervical osteophytes are seen in 20%–30% of the geriatric population, they are an unusual (and treatable) cause of dysphagia. Dysphagia occurs because of mechanical blockage as well as inflammation of the peripharyngeal and peri-oesophageal tissue. As enlarged cervical osteophytes may be an incidental finding, it is important to exclude other potential causes, such as neoplasm.1,2

Lateral radiograph of the cervical spine showing multiple enlarged anterior and bridging cervical osteophytes, with the most prominent bridging osteophyte between the C4 and C5 vertebrae (arrow).