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!
|
| _version_ | 1850099194062176256 |
|---|---|
| author | Patrick Kai Chun Chan Kavina Shah Ajay Sahu Maxine Hogarth |
| author_facet | Patrick Kai Chun Chan Kavina Shah Ajay Sahu Maxine Hogarth |
| author_sort | Patrick Kai Chun Chan |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-2f3981b9320e4e30aff167c96fd5f304 |
| institution | DOAJ |
| issn | 1930-0433 |
| language | English |
| publishDate | 2025-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj-art-2f3981b9320e4e30aff167c96fd5f3042025-08-20T02:40:32ZengElsevierRadiology Case Reports1930-04332025-10-0120105051505510.1016/j.radcr.2025.06.106Schmorl’s nodes and vertebral fractures: A diagnostic dilemmaPatrick Kai Chun Chan0Kavina Shah1Ajay Sahu2Maxine Hogarth3Department of Postgraduate Education, Ealing Hospital, London North West University Healthcare NHS Trust, London, UK; Corresponding author.Department of Rheumatology, Ealing Hospital, London North West University Healthcare NHS Trust, London, UKDepartment of Radiology, Ealing Hospital, London North West University Healthcare NHS Trust, London, UKDepartment of Rheumatology, Ealing Hospital, London North West University Healthcare NHS Trust, London, UKA 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.http://www.sciencedirect.com/science/article/pii/S1930043325006351Schmorl’s nodeVertebral fragility fractureOsteoporosis |
| spellingShingle | Patrick Kai Chun Chan Kavina Shah Ajay Sahu Maxine Hogarth Schmorl’s nodes and vertebral fractures: A diagnostic dilemma Radiology Case Reports Schmorl’s node Vertebral fragility fracture Osteoporosis |
| title | Schmorl’s nodes and vertebral fractures: A diagnostic dilemma |
| title_full | Schmorl’s nodes and vertebral fractures: A diagnostic dilemma |
| title_fullStr | Schmorl’s nodes and vertebral fractures: A diagnostic dilemma |
| title_full_unstemmed | Schmorl’s nodes and vertebral fractures: A diagnostic dilemma |
| title_short | Schmorl’s nodes and vertebral fractures: A diagnostic dilemma |
| title_sort | schmorl s nodes and vertebral fractures a diagnostic dilemma |
| topic | Schmorl’s node Vertebral fragility fracture Osteoporosis |
| url | http://www.sciencedirect.com/science/article/pii/S1930043325006351 |
| work_keys_str_mv | AT patrickkaichunchan schmorlsnodesandvertebralfracturesadiagnosticdilemma AT kavinashah schmorlsnodesandvertebralfracturesadiagnosticdilemma AT ajaysahu schmorlsnodesandvertebralfracturesadiagnosticdilemma AT maxinehogarth schmorlsnodesandvertebralfracturesadiagnosticdilemma |