Case History
This 14 year old male patient presents with persistent mid to lower thoracic pain aggravated by playing football.
Discussion
Notice the anterior wedging of the vertebral bodies of T7, T8 and T9. There are Schmorl’s node indentations present on the anterior inferior endplates of T7, T8 and T9. The anterior wedging of these vertebral segments are associated with irregularity of the anterior growth plates of these respective thoracic segments. There is a moderate increase in the thoracic kyphosis noted. These findings are consistent with the diagnostic of Scheuermann’s disease. Scheuermann’s disease is a spinal disorder of unknown cause affecting the adolescent athlete leading to pain and occasionally cosmetic deformity. Most patients are between the ages of 13 and 17 with a male predominance. It most commonly affects the mid to lower thoracic regions. Pain, fatigue and an increase in the anterior kyphosis is often seen. The radiological features should include at least three contiguous vertebrae with each creating an anterior wedged appearance of at least 5 degrees, irregular vertebral endplates often associated with Schmorl’s nodes and decreased disc height along with increased kyphosis. Conservative treatment and management is recommended and reduction in physical activity during the acute symptoms is recommended.
Reference
Yochum and Rowe, Essentials of Skeletal Radiology, Lippincott, Williams & Wilkins Publishers, 2005