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Schmorl’s node case presentation

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It is a case of schmorl's node in young boy not common clinical presentation. Basically it is degenerative lesion of wear and tear as age advance

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Schmorl’s node case presentation

  1. 1. Schmorl’s node A Case presentation By: Dr Rekha Khare MD Radiology
  2. 2. Schmorl’s node: • Christian George Schmorl German pathologist named it as Schmorl’s Node in 1927
  3. 3. Clinical Presentation: • MRI has been done for a young school boy aged 18years. His main complaint was chronic backache all over from neck to down for last few years • On examination there was no remarkable clinical sign There was no any other constitutional symptom. • Routine laboratory examination was within normal limit.
  4. 4. MRI Cervico-dorsal spine…… • Sagittal T2 sequence:
  5. 5. MRI Lumbar spine T2 sagittal Planning film:
  6. 6. MRI Lumbar region…… • Sagittal T1 sequence:
  7. 7. MRI Lumbar spine L4-5….. • Axial T1 & T2 sequence:
  8. 8. MRI Lumbar spine…… • Coronal T2 sequence:
  9. 9. MRI Whole spine……. • Sagittal screening whole spine:
  10. 10. MRI Lumbar Spine serial sequence • Lumbar curvature seems to be maintained • Vertebrae are with slightly reduced height--flat vertebrae. • Multilevel disc bulging, few are with low signal/ dehydrated more at L2-3,L3-4
  11. 11. MRI FINDING CONTD……. • T1 and T2 weighted sagittal MR scan of the lumbar spine showing rounded fairly central endplate cortical defects/ schmorls node with herniated disc material at T12,L1,2,5.
  12. 12. MRI FINDING CONTD……. • No significant high signal due to inflammation & oedma is noted in the bone marrow surrounding the schmorls node in T2 weighted slice • IV Disc spaces are not remarkably reduced
  13. 13. MRI SCREENING OF SPINE……. • Central schmorls node at lower cervical 5,6,7 and multiple lower thoracic vertebrae. Minimal marginal defect at T1,2,3 • Soft tissue humping in cervical region.
  14. 14. DISCUSSION: • Vertebral end plate are critical for maintaining disc function yet like other components of the disc endplate are vulnerable to degeneration.
  15. 15. Discussion contd……. • Schmorls node is Protrusion of the cartilage of the intervertebral disc through vertebral body end plate & into adjacent vertebra. • Protrusion may contact the marrow of the vertebra leading to inflammation
  16. 16. Discussion contd……. • Etiology is controversial. Schmorls node is fairly common esp with minor degeneration of the aging spine but they could be seen in younger spine often no symptom • May simply reflect Wear & Tear of the spine
  17. 17. Discussion contd……. • . It is believed that schmorls node develop following back trauma • Nucleus pulposus pressure on the weakest part of endplate
  18. 18. Discussion contd……. • They may also reflect that bone strength was at one time some what compromised perhaps due to vitamin D deficiency
  19. 19. Discussion contd……. • . It was yet to confirmed with studies if heavy lifting is done at younger age before the vertebra are completely ossified such as in young farm workers.
  20. 20. Discussion contd……. • It is among the diagnostic criteria of Scheuermann’s disease • A Limbus vertebra is closely related to schmorls node, detected on x-ray better on CT or MRI
  21. 21. REFERENCES: 1. Dr Tim Luijks and Dr Behrang Amin etal.: Schmorl node . Radiopaedia.org.com 2. Mc Fadden KD, Taylor JR: End Plate Lesion of Lumbar spine Spine 1989, 14(8):867-869 3. Robert J.Moore: The vertebral end plate: Disc degeneration,disc regeneration. EurSpine J.Aug 2006(suppl.3)333-337 4. Takahashi K, Miyazaki T, Ohnari H, Tonita K: Schmorls nodes and low back pain- Analysis of magnetic resonance of imaging finding in symptomatic and asymptomatic individual, Eur Spine J.1995,4(1)56-9 5. Leo F. Czervionke and Douglous S. Fenton: Imaging painful spine disorder 6. Dr Henry Knipe and Dr Frank Gailard etal. : Scheuermann disease , Radiopaedia.org .Com •

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