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Rugger jersey spine (hyperparathyroidism)

Last revised by Liz Silverstone ◉ ◈ on 21 Dec 2024

Citation, DOI, disclosures and article data

Citation:

Gaillard F, Silverstone L, Lee S, et al. Rugger jersey spine (hyperparathyroidism). Reference article, Radiopaedia.org (Accessed on 21 Dec 2024) https://doi.org/10.53347/rID-1999

DOI:

https://doi.org/10.53347/rID-1999

Permalink:

https://radiopaedia.org/articles/1999

rID:

1999

Article created:

2 May 2008, Frank Gaillard ◉ ◈

Disclosures:

At the time the article was created Frank Gaillard had no recorded disclosures.

View Frank Gaillard's current disclosures

Last revised:

21 Dec 2024, Liz Silverstone ◉ ◈

Disclosures:

At the time the article was last revised Liz Silverstone had no financial relationships to ineligible companies to disclose.

View Liz Silverstone's current disclosures

Revisions:

28 times, by 21 contributors - see full revision history and disclosures

Systems:

Musculoskeletal, Spine

Sections:

Signs

Synonyms:

Rugby jersey sign
Rugger-jersey sign

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.

Pathology

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

Paget disease
- picture frame vertebral body
osteopetrosis
- sandwich vertebrae
reverse rugger jersey spine
severe osteoporosis with compression fractures

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