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Radiologic Findings in Two Cases of Acute Schmörl's Nodes

Elisenda GrivéGo,a, Alex Roviraa, Jaume Capelladesa, Antoni Rivasa and Salvador Pedrazaa

a From the Magnetic Resonance Unit (I.D.I). Department of Radiology, Vall d'Hebron University Hospital, Barcelona, Spain.



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  		FIG 1. A 68-year-old woman with acute back pain of 15-day duration. Schmörl's node formation with herniation of calcified disk.

A, T1-weighted image spin-echo (600/15 [TR/TE]) shows diffuse low signal intensity in the T11 vertebral body and spondylolisthesis of L5–S1. T2-weighted spin-echo image (2200/80) shows only slight increase in signal intensity near inferior endplate (arrow).

B, Increased uptake on bone scintigraphy over T11 vertebra 6 days later.

C, CT scan depicts a radiolucent lesion in lower portion of T11 with central dense bone 14 days later.

D, Small defect (arrow) in inferior vertebral endplate of T11 and decrease in vertebral hypointensity on T1-weighted spin-echo image (500/15) 3 months later.

E, CT coronal reformatted images. Disk calcification herniating through vertebral bony defect.

F, T1-weighted spin-echo image (460/17) and T2-weighted spin-echo image (5000/112) (arrow) show a typical Schmörl's node at 1-year follow-up.



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  		FIG 2. A 38-year-old man with 6-week history of lumbar pain related to physical exertion. Schmörl's node formation on neoplastic vertebra.

A, CT shows lytic lesion in L3 vertebral body without sclerotic margin.

B, T2-weighted spin-echo image (5000/90) shows hyperintense lesion in L3. Nucleus pulposus intranuclear clefts on L2–L3 and L3–L4 disks bend toward vertebral endplate.

C, T1-weighted spin-echo image (450/15) shows vertebral hypointensity and minimal irregularity on vertebral endplates.

D, Enhanced T1-weighted spin-echo image (450/15) shows two nonenhanced Schmörl's nodes of both endplates.

E, T2-weighted spin-echo image (5000/90) 3 months later shows a less hyperintense vertebral infiltrating lesion that extends to epidural space (arrow) and contains two Schmörl's nodes.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X