Rugger jersey spine (hyperparathyroidism)

Last revised by Sze Yuen Lee on 28 Nov 2023

Rugger jersey spine describes the prominent endplate densities at multiple contiguous vertebral levels to produce an alternating sclerotic-lucent-sclerotic appearance. This mimics the horizontal stripes of a rugby jersey.

This term and pattern are distinctive for hyperparathyroidism 1. However and confusingly, some authors use the term rugger jersey for osteopetrosis, although most would assume the term refers to hyperparathyroidism.


In response to increased bone resorption due to excess parathyroid hormone (PTH) secretion and subsequent loss of bone mass, osteoblasts form an increased amount of osteoid that does not contain hydroxyapatite but does appear opaque on radiographs. The sclerotic bands on the superior and inferior endplates of the vertebral bodies represent accumulations of excess osteoid and appear opaque because of their increased volume when compared to normal bone 1.

Differential diagnosis

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