Scheuermann's Disease

There is fragmentation and irregularity of the endplates of multiple vertebral bodies.
- Many of the defects are located anteriorly and there is some wedging present.
- Findings are well seen in a detailed view.
Although flattening of the vertebral bodies is difficult to appreciate in the AP view, it is apparent in a different patient with the same disorder.

Findings are compatible with Scheuermann's Disease.

You may wish to review some facts concerning Scheuermann's Disease:

A disorder of the spine discovered in adolescents.
Formerly thought to be secondary to osteonecrosis, now felt to be secondary to (familial) congenital weakness in endplates.
For diagnosis, three adjacent vertebral bodies must be involved with 5 degrees or more of wedging.
Clinical findings variable but may lead to painful thoracic scoliosis exacerbated by exertion.
Radiographically, undulating endplates are punctuated by radiolucent cartilagenous (Schmorl's) nodes.
DDx: other diseases leading to softening of endplates (e.g., infection, HPTH, osteoporosis, trauma, Paget's, etc.)

Case courtesy Rhona Orentlicher, M.D., Department of Radiology, SUNY HSCB, Brooklyn, NY.

Ref: Resnick, D., Bone and Joint Imaging, W.B. Saunders, Philadelphia, PA, 1989, pp 991-992.

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