Musculoskeletal ImagingSchmorl's node
(Christian Georg Schmorl, 1861 - 1932, German pathologist), protrusion of intervertebral disc material through a break in the subchondral bone plate, with displacement of this material into the vertebral body, leading to an abnormal contour of the spine on radiographs. Schmorl's nodes, which are also termed cartilaginous nodes, may occur in numerous conditions (Table 1). They may result from any disease or condition that leads to weakening of the cartilaginous endplate or subchondral bone of the vertebral body.
Schmorl's node, Table 1. Some conditions associated with Schmorl's nodes.
Schmorl's nodes may sometimes be associated with a vacuum phenomenon or fish vertebrae.
Radiographically Schmorl's nodes appear as a radiolucent lesion within the vertebral body surrounded by helmet-shaped sclerosis that borders on the intervertebral disc. CT scans and MR imaging also show characteristic features (Fig.1).
A distinct type of cartilaginous node formation, producing an abnormality termed a limbus vertebra, is characterized by intraosseous penetration of disc material at the junction of the cartilaginous endplate and the bony rim in children in whom the developing apophyses have not yet fused with the remaining portion of the vertebral body. In some cases traumatically induced posterior limbus vertebrae lead to discal herniation.
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a. Axial CT scan demonstrates a rounded radiolucency with a thin rim of sclerosis in the L3 vertebral body.
b, c. Sagittal T1-weighted (b) and T2-weighted (c) MR images demonstrate displacement of disk material through the superior and inferior endplates of the L3 vertebral body.
(Courtesy of Robert Skib, MD, Tulsa, Oklahoma)
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Schmorl's node, Fig.1 (a) | | Schmorl's node, Fig.1 (b) | | Schmorl's node, Fig.1 (c) |