Schmorl's node
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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:
Radiology
Schmorl's node. (WC)
DDx - radiologic:
- Plasma cell neoplasm.
- Metastatic carcinoma.
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:
- Histologically, Schmorl's node is considered a cousin of avascular necrosis of the femoral head.[6]
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LESION, L4 VERTEBRA, BIOPSY: - BENIGN BONE AND BONE MARROW. - NEGATIVE FOR MALIGNANCY.
Micro
The sections show woven bone with slightly thickened bony trabeculae. Bone with some empty lacunae is seen focally. A small amount of benign fibrotic tissue with small blood vessels is present. The bone marrow present has all three lineages. No atypical cells are apparent.
See also
References
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 6.0 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.