Motivated by medical terminology applications, we investigate the decidability of the well known expressive DL, SHIQ, extended with role inclusion axioms (RIAs) of the form R ◦ S P. We show that this extension is undecidable even when RIAs are restricted to the forms R◦S R or S ◦R R, but that decidability can be regained by further restricting RIAs to be acyclic. We present a tableau algorithm for this DL and report on its implementation, which behaves well in practise and provides important additional functionality in a medical terminology application. 1 Motivation The description logic (DL) SHIQ [Horrocks et al., 1999; Horrocks and Sattler, 2002b] is an expressive knowledge representation formalism that extends ALC [Schmidt-Schauß and Smolka, 1991] (a notational variant of the multi modal logic K [Schild, 1991]) with qualifying number restrictions, inverse roles, role inclusion axioms (RIAs) R S, and transitive roles. The development of SHIQ was motivated by several applicati...