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Edematous Schmorl's nodes on thoracolumbar MR imaging: characteristic patterns and changes over time
Hung-Ta H Wu1, William B Morrison, Mark E Schweitzer
1Department of Radiology, Taipei Veterans General Hospital, National Yang Ming University, 201 Shih Pai Road Sec. 2, Taipei 112, Taiwan.
Skeletal Radiology
|February 14, 2006
Summary
Edematous Schmorl's nodes can change in size and signal over time, with some developing concentric rings. Concentric ring formation helps rule out fracture, infection, or malignancy in these spinal nodes.
Area of Science:
- Radiology
- Spinal Imaging
- Orthopedic Research
Background:
- Schmorl's nodes are common vertebral body abnormalities.
- Edematous Schmorl's nodes represent an active or subacute process.
- Understanding their evolution is crucial for differential diagnosis.
Purpose of the Study:
- To characterize the imaging patterns of edematous Schmorl's nodes.
- To describe the temporal evolution of these nodes on serial MRI.
- To identify imaging features associated with specific pathologies.
Main Methods:
- Retrospective analysis of 84 edematous Schmorl's nodes in 47 patients.
- Serial MRI evaluation over an average of 17 months.
- Assessment of node characteristics, surrounding marrow changes, and associated spinal pathologies.
Main Results:
- Most nodes were located in the L3 and L4 vertebral bodies.
- Associated findings included disc bulging (55%) and fracture (10%).
- Concentric rings in surrounding marrow were observed in 38% and had a high negative predictive value for other pathologies.
Conclusions:
- While many edematous Schmorl's nodes are stable, a significant minority show evolution in size and signal.
- Concentric ring formation is a notable finding with diagnostic implications.
- These findings aid in differentiating idiopathic Schmorl's nodes from those associated with fracture, infection, or malignancy.
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