Diffuse idiopathic skeletal hyperostosis presenting with thoracic outlet syndrome and dysphagia.

A case of diffuse idiopathic skeletal hyperostosis (DISH) presenting with thoracic outlet syndrome and dysphagia is reported. Although extraspinal manifestations have been reported in these patients, thoracic outlet syndrome, particularly the anatomical anomaly found at operation, is previously unreported in patients with DISH. In addition to discussing DISH and thoracic outlet syndrome, we readvocate the anterior approach for 1st rib resection that was introduced in 1967 by Gol and associates. The direct visualization offered by this approach allowed us to avoid a potential injury to the brachial plexus that may have occurred had the transaxillary approach been used.