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

1. Schmorl’s node
A Case presentation
By: Dr Rekha Khare
MD Radiology

2. Schmorl’s node:
• Christian George Schmorl
German pathologist named it
as Schmorl’s Node in 1927

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. MRI Cervico-dorsal spine……
• Sagittal T2 sequence:

12. MRI Lumbar spine T2 sagittal
Planning film:

21. MRI Lumbar region……
• Sagittal T1 sequence:

27. MRI Lumbar spine L4-5…..
• Axial T1 & T2 sequence:

30. MRI Lumbar spine……
• Coronal T2 sequence:

33. MRI Whole spine…….
• Sagittal screening whole spine:

36. 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

37. 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.

38. 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

39. 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.

40. DISCUSSION:
• Vertebral end plate are critical for
maintaining disc function yet like other
components of the disc endplate are
vulnerable to degeneration.

41. 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

42. 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

43. Discussion contd…….
• . It is believed that schmorls node develop
following back trauma
• Nucleus pulposus pressure on the
weakest part of endplate

44. Discussion contd…….
• They may also reflect that bone strength
was at one time some what compromised
perhaps due to vitamin D deficiency

45. 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.

46. 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

47. 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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