Schmorl's nodes

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Schmorl's nodes are protrusions of the cartilage of the intervertebral disc through the vertebral body endplate and into the adjacent vertebra.1


Contents

Presentation

Schmorl's Nodes (SNs): On this lateral T2-weighted MRI image you can see two SNs. Note the disc below the L3 vertebra is white, healthy, and non-degenerated. The L3 disc has been prematurely degenerated (black appearance) as the result of a huge traumatically induced Schmorl's Node (white arrows) which occurred as the result of a ski jumping accident. The L2 upper front corner of the vertebra has suffered an old compression fracture (white arrow) and another good sized SN is noted in the upper vertebral end-plate. The disc, although not as arid, has collapsed by about 50% (as has the L2/3 disc) which is classic of DDD.[1]

The protrusions may contact the marrow of the vertebra, leading to inflammation. The protrusions are also associated with necrosis of the vertebral bone and the question of whether these protrusions and inflammation cause the necrosis, or whether the cartilage migrates into areas that have become necrotic due to other conditions, is under investigation.

They may or may not be symptomatic, and their etiological significance for back pain is controversial.

Diagnosis

Schmorl's nodes can be detected radiographically, although they can be imaged better by CT or MRI.



Causes

It is believed that Schmorl's nodes develop following back trauma, although this is incompletely understood.

Incidence/prevalence

Schmorl's nodes are found in 40 - 75% of autopsies.


References

  1. Who Named It?
  2. Schmorl's nodule
  3. McFadden KD, Taylor JR (1989). "End-plate lesions of the lumbar spine". Spine 14 (8): 867-9. PMID 2781398.
  4. Peng B, Wu W, Hou S, Shang W, Wang X, Yang Y (2003). "The pathogenesis of Schmorl's nodes". The Journal of bone and joint surgery. British volume 85 (6): 879-82. PMID 12931811.
  5. Takahashi K, Miyazaki T, Ohnari H, Takino T, Tomita K (1995). "Schmorl's nodes and low-back pain. Analysis of magnetic resonance imaging findings in symptomatic and asymptomatic individuals". European spine journal 4 (1): 56-9. PMID 7749909.
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