venerdì 5 settembre 2008

Scheuermann’s disease (adolescent kyphosis)


Sagittal T1 and T2 weighted, and STIR MRI images of the thoracic spine demonstrate exaggerated thoracic kyphosis, with multiple levels of mild anterior vertebral body wedging, anterior disc space loss (with anterior disc bulging), disc desiccation, endplate irregularity, and Schmorl’s nodes. Axial image demonstrates increased AP diameter of the vertebral body. Coronal images show a mild thoracic dextroscoliosis.

Differential diagnosis:
- Scheuermann’s disease (adolescent kyphosis)
- Osteochondrodystrophy
- Developmental notching of anterior vertebrae

Diagnosis: Scheuermann’s disease (adolescent kyphosis)

Key Points

Vertebral osteochondrosis.
Kyphotic deformity of the thoracic (75%) or thoracolumbar (25%) spine in teenagers (onset at puberty).
Disorder consisting of vertebral wedging, endplate irregularity, and narrowing of intervertebral disk space.
Anterior wedging of vertebral body > 5 degrees.
Increased AP diameter of vertebral body.
Kyphosis of > 40 degrees. Loss of lordosis. Scoliosis.
Schmorl's nodes (intravertebral herniation of nucleus pulposus into vertebral body.
Anterior wedging of at least 1 vertebral body; usually 3-5 vertebral bodies involved.
Prevalence – 31% of male, 21% of female patients with back pain.

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