Schmorl’s nodes and vertebral fractures: A diagnostic dilemma
A previously healthy 42-year-old man presented with sudden onset back pain whilst playing football. A T8 vertebral fragility fracture was diagnosed following X-ray and MRI thoracic spine, which demonstrated grade 1 compression. In addition, osteopenia was reported on dual-energy X-ray absorptiometry...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-10-01
|
| Series: | Radiology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043325006351 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | A previously healthy 42-year-old man presented with sudden onset back pain whilst playing football. A T8 vertebral fragility fracture was diagnosed following X-ray and MRI thoracic spine, which demonstrated grade 1 compression. In addition, osteopenia was reported on dual-energy X-ray absorptiometry scan (DXA), which revealed a T-score of −1.8 in the lumbar spine. A follow-up MRI carried out after 18 months, reviewed by the metabolic bone clinic (MBC)-radiology multidisciplinary team, suggested features compatible with a ruptured Schmorl’s node. The DXA was re-reviewed by an MBC specialist and revealed bone density within expected range for age based on a Z-score above −2.0 using the ISCD 2023 recommended diagnostic criteria for men aged under 50. A conservative treatment approach was taken, sparing the patient from bisphosphonate therapy. This case highlights the importance of considering a ruptured Schmorl’s node in the differential of vertebral compression, especially in younger patients with no risk factors, and assessing bone density using Z-score definition rather than T- scores. |
|---|---|
| ISSN: | 1930-0433 |