Common (1/3 of population); more common in men than women
Extrusion, invagination, protrusion of intervertebral disc material through a break in the subchondral end plate of a vertebral body
The disk material is displaced into the vertebral body
Most common in thoracolumbar spine
May occur spontaneously or in association with
Scheuermann’s disease (juvenile kyphosis)
Trauma
Hyperparathyroidism
Osteoporosis, other metabolic conditions
Infection
Neoplasm
Clinical Findings
Are generally considered to be asymptomatic although cases are reported of acute pain
Imaging Findings
Lucent lesion, most often in middle or posterior portion of vertebral body
At margin with disc space
More commonly involves inferior endplate
Usually posterior of middle portion of endplate
Sclerotic margin
On MR
Schmorl’s node generally has same signal characteristics as adjacent disk
Best seen on sagittal images
Defect in endplate is often seen
Differential Diagnosis
Limbus vertebra
Treatment
Usually asymptomatic
If symptomatic, conservative symptomatic treatment
Schmorl's node. Black arrow points to well defined marginal lesion in L3 with sclerotic margins. There is associated degenerative osteophyte formation (white arrow). On coronal reconstruction, the marginal lesion is seen (blue arrow) and there is a vacuum disk phenomenon present from the degenerated disk below.
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