Difference between revisions of "Schmorl's node"

From Libre Pathology
Jump to navigation Jump to search
Line 23: Line 23:
*Subchondral [[necrosis]] of bone - '''key feature'''.
*Subchondral [[necrosis]] of bone - '''key feature'''.
**Loss of osteocytes within the bony trabeculae.
**Loss of osteocytes within the bony trabeculae.
*Bone marrow cavity fibrosis with loss of adipocytes (reactive process).
*Reactive woven bone:
**Thickened trabeculae.
**Increased numbers of osteoblasts and osteoclasts.
*Bone marrow cavity fibrosis with small blood vessels and loss of adipocytes (reactive process).


Note:
Note:

Revision as of 11:33, 28 October 2013

Schmorl's node is a benign pathology of the vertebral column in which part of the vertebral disc herniates into a vertebra.[1]

General

  • Very common.[2]
  • Essentially a radiologic diagnosis.
  • Not associated with osteopenia.[3]

Clinical:

  • May cause severe back pain.[4]
  • May be associated with trauma.[5]

Radiology

DDx - radiologic:

Microscopic

Features:[6]

  • Subchondral necrosis of bone - key feature.
    • Loss of osteocytes within the bony trabeculae.
  • Reactive woven bone:
    • Thickened trabeculae.
    • Increased numbers of osteoblasts and osteoclasts.
  • Bone marrow cavity fibrosis with small blood vessels and loss of adipocytes (reactive process).

Note:

See also

References

  1. Mattei, TA.; Rehman, AA. (Aug 2013). "Schmorl's nodes: current pathophysiological, diagnostic, and therapeutic paradigms.". Neurosurg Rev. doi:10.1007/s10143-013-0488-4. PMID 23955279.
  2. Dar, G.; Peleg, S.; Masharawi, Y.; Steinberg, N.; May, H.; Hershkovitz, I. (Apr 2009). "Demographical aspects of Schmorl nodes: a skeletal study.". Spine (Phila Pa 1976) 34 (9): E312-5. doi:10.1097/BRS.0b013e3181995fc5. PMID 19531985.
  3. González-Reimers, E.; Mas-Pascual, M.; Arnay-De-La-Rosa, M.; Velasco-Vázquez, J.; Santolaria-Fernández, F. (Jan 2002). "Schmorl nodes: lack of relationship between degenerative changes and osteopenia.". Radiology 222 (1): 293-4. doi:10.1148/radiol.2221011147. PMID 11756740.
  4. Abu-Ghanem, S.; Ohana, N.; Abu-Ghanem, Y.; Kittani, M.; Shelef, I. (Jun 2013). "Acute schmorl node in dorsal spine: an unusual cause of a sudden onset of severe back pain in a young female.". Asian Spine J 7 (2): 131-5. doi:10.4184/asj.2013.7.2.131. PMID 23741552.
  5. Walters, G.; Coumas, JM.; Akins, CM.; Ragland, RL. (Oct 1991). "Magnetic resonance imaging of acute symptomatic Schmorl's node formation.". Pediatr Emerg Care 7 (5): 294-6. PMID 1754491.
  6. 6.0 6.1 Peng, B.; Wu, W.; Hou, S.; Shang, W.; Wang, X.; Yang, Y. (Aug 2003). "The pathogenesis of Schmorl's nodes.". J Bone Joint Surg Br 85 (6): 879-82. PMID 12931811.