= SPINAL OSTEOCHONDROSIS = KYPHOSIS DORSALIS JUVENILIS = V ERTEBRAL EPIPHYSITIS

[Holger Werfel Scheuermann(1877–1960), Danish orthopedic surgeon and radiologist, head physician to the navy]

= disorder consisting of vertebral wedging + endplate irregularity + narrowing of intervertebral disk space

Prevalence: in 31% (21%) of males (females) with back pain

Age: onset at puberty

Location: lower thoracic / upper lumbar vertebrae; in mild cases limited to 3–4 vertebral bodies

• anterior wedging of vertebral body of >5°
• increased anteroposterior diameter of vertebral body
• slight narrowing of disk space
• kyphosis of >40°/ loss of lordosis; scoliosis
• Schmorl nodes = intravertebral herniation of nucleus pulposus = depression in contour of endplate in posterior half of vertebral body; found in up to 30% of adolescents + young adults
• flattened area in superior surface of epiphyseal ring anteriorly = avulsion fracture of ring apophysis due to migration of nucleus pulposus through weak point between ring apophysis + vertebral endplate (fusion of ring apophysis usually occurs at about 18 years of age)
• detached epiphyseal ring anteriorly

DDx:

1. Developmental notching of anterior vertebrae (NO wedging or Schmorl nodes)
2. Osteochondrodystrophy (earlier in life, extremities show same changes)