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Virtual Pediatric Hospital: Paediapaedia: Scheuermann Disease Paediapaedia: Musculoskeletal Diseases

Scheuermann Disease

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
Back pain in 50% of patients, rarely seen before 11 years old.

Etiology/Pathophysiology:
Due to irregularity of ossification of one or more vertebral endplates. Fissures develop in the vertebral cartilage and endplates and they open up and there is herniation of disc material, fibrosis follows and Schmorl's nodes (sclerosis) forms in reaction.

Pathology:
Not applicable

Imaging Findings:
Diagnosis is based on radiological evidence of kyphosis exceeding 35 degrees with at least one vertebral body wedged 5 or more degrees. Most frequently seen between T7-T10 but it can be seen anywhere from T4 to L4. One third of the patients have a mild scoliosis. On plain film see intervertebral disc narrowing that is greatest anteriorly, Schmorl's nodes in anterior or central portions of the discs, anterior wedging of the vertebral bodies with irregular margins and indistinct cortical outlines, and irregular ossification of the ring apophyses.

DDX:

References:
See References Chapter.

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