Elderly man with dysphagia and esophageal perforation from an anterior cervical osteoarthritic osteophytee

An 85-year-old man with multiple comorbidities presented with dysphagia and developed stridor and respiratory distress, ultimately resulting in intubation due to an anterior, cervical osteoarthritic osteophyte. The osteophyte had eroded into his esophagus and compromised his airway. To our knowledge, this is the only documented case of stridor and respiratory failure in this etiologic situation. We review the common risk factors and presenting symptom patterns for this disease and cite recommendations for diagnosis, management, and disposition in the emergency department and critical care setting. As our patient population continues to age, one must consider the rare, yet possible, osteoarthritic osteophyte as the etiology of dysphagia, dyspnea, or stridor.