A rare cause of kyphosis with low backache - “Scheuermann’s disease”: “Osteochondritis deformans juvenilis dorsi”

Vipin Kumar Bakshi, Jai Chowdhary, Anand Prakash Verma, Mool Chand Baberwal

Abstract


An uncommon case of Scheuermann’s disease (Apprentice’s spine) is being reported for two simple reasons- firstly, to show that it is a self-limiting disease which needs only proper observation, extension exercises & extension spinal brace and secondly, it becomes a diagnostic riddle when osteolytic lesion is seen in epiphyseal plates of adjacent vertebral bodies in an adolescent. Radiology and Imaging are needed for the early and accurate diagnosis and to differentiate it from other causes of kyphosis. Hence, it stressed the need to publish this condition not only for its rarity but also for its diagnostic puzzle to differentiate it from other conditions. Here we report a case of an adolescent male of 17 years with poor posture/slouching, fatigue, mild pain in lower thoracic area of spine (low backache), stiffness and loss of flexibility with radiological and MRI findings.


Keywords


Kyphosis, Adolescent kyphosis, Scheuermann’s Disease, Low backache, Osteochondritis deformans juvenilis dorsi, Skiagram, MRI-Magnetic resonance imaging

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References


Scheuermann HW. The classic: Kyphosis dorsalis juvenilis. Clin Orthop. 1977;128:5-7.

Robert A. Dickson. Spinal deformities in children. In: Robert B. Duthie, George Bentle, eds. Mercer’s Orthopaedic Surgery. 9th ed. New York: Oxford University Press, Inc.; 1996: 504-507.

Sorenson KH. Scheuermann’s juvenile kyphosis: clinical appearances, radiography, aetiology, and prognosis. In: Sorenson KH, eds. A Book. 1st ed. Copenhagen: Munksgaard; 1964.

Swischuk LE, John SD, Allbery S. Disk degenerative disease in childhood: Scheuermann's disease, Schmorl’s nodes, and the limbus vertebra. MRI findings in 12 patients. Pediatr Radiol. 1998;28:334-8.

Lowe TG. Scheuermann’s disease. Orthop Clin North Am. 1999;30:475-87.

Ferguson AB. The etiology of pre-adolescent kyphosis. J Bone Joint Surg [Am]. 1956;38:149-57.

Bradford D. Vertebral osteochondrosis (Scheuermann’s kyphosis). Clin Orthop. 1980;122:83-90.

Ippolito E, Bellocci M, Montanaro A, Ascani E, Ponseti IV. Juvenile kyphosis: an ultrastructural study. J Pediatr Orthop. 1985;5:315-22.

Ippolito E, Ponseti IV. Juvenile kyphosis: histological and histochemical studies. J Bone Joint Surg [Am]. 1981;63:175-82.

Schmorl G, Junghans H. Schmorl’s node. In: Schmorl G, Junghans H, eds. The Human Spine in Health and Disease. 2nd ed. New York, NY: Grune & Stratton; 1971: 158-172.

Roberts S, Menage J, Urban JPB. Biochemical and structural properties of the cartilage endplate and its relation to the intervertebral disc. Spine. 1989;14:166-74.

Peng B, Wu W, Hou S, Shang W, Wang X, Yang Y. The pathogenesis of Schmorl’s nodes. J Bone Joint Surg Br. 2003;85:879-82.

Vernon-Roberts B, Pirie CJ. Degenerative changes in the intervertebral discs and their sequelae. Rheum Rehabil. 1977;16:13-21.

Hilton RC, Ball J, Benn RT. Vertebral end-plate lesions (Schmorl’s nodes) in the dorso-lumbar spine. Ann Rheum Dis. 1976;35:127-32.

Paajanen H, Alanen A, Erkintalo M, Salminen JJ, Katevuo K. Disc degeneration in Scheuermann disease. Skeletal Radiol. 1989;18:523-6.

Stoddard A, Osborn JF. Scheuermann’s disease or spinal osteochondrosis: its frequency and relationship with spondylosis. J Bone Joint Surg Br. 1979;61:56-8.

Cleveland RH, Delong GR. The relationship of juvenile lumbar disc disease and Scheuermann’s disease. Pediatr Radiol. 1981;10:161-4.

Swischuk LE, John SD, Allbery S. Disk degenerative disease in childhood: Scheuermann’s disease, Schmorl’s nodes, and the limbus vertebra: MRI findings in 12 patients. Pediatr Radiol. 1998;28:334-8.

19. Otsuka NY, Hall JE, Mah JY. Posterior fusion for Scheuermann’s kyphosis. Clin Orthop. 1990;251:134-9.

Papagelopoulos PJ, Klassen RA, Peterson HA, Dekutoski MB. Surgical treatment of Scheuermann’s disease with segmental compression instrumentation. Clin Orthop. 2001;386:139-49.