Scheuermann disease

Scheuermann disease, also known as juvenile kyphosisjuvenile discogenic disease 11 or vertebral epiphysitis, is a common condition which results in kyphosis of the thoracic or thoracolumbar spine. The diagnosis is usually made on plain film.

  • occurs in ~5% (range 0.4-8%) of the general population 2
  • slight male predominance

Its exact etiology is unknown but a proposed mechanism is by aseptic necrosis of the ring vertebral apophyses. Excess axial spine load due to heavy weight lifting may also contribute.

There is a strong hereditary predisposition (perhaps autosomal dominant) with a high degree of penetrance and variable expressivity.

Location

Occurs in the thoracic spine in up to 75% of cases, followed by the thoracolumbar spine combined and occasionally lumbar and rarely cervical spine. 

Variants

Some authors have proposed the term lumbar Scheuermann disease 4-5 for a variant affecting the lumbar region.

General

To apply the label of classical Scheuermann disease, one needs to meet a number of criteria (Sorensen classification 9):

  • thoracic spine kyphosis >40 deg (normal 25-40 deg) or
  • thoracolumbar spine kyphosis >30 deg (normal 0 deg)

and

  • at least 3 adjacent vertebrae demonstrating wedging of >5 degrees

The condition is associated with Schmorl nodes, limbus vertebraescoliosis (~25%) and spondylolisthesis

Other signs include:

  • vertebral end plate irregularity due to extensive disc invagination
  • intervertebral disc space narrowing, more anteriorly

Management is largely dependent on the degree of kyphosis:

  • <50˚: conservative, stretching, postural changes
  • 50-75˚: brace
  • >75˚: surgery

It is named after Danish orthopaedic and radiologist Holger Werfel Scheuermann, who first described it in 1920 as Osteochondritis deformans juvenilis dorsi 10.

Share Article

Article Information

rID: 2022
Synonyms or Alternate Spellings:
  • Scheuermann's kyphosis
  • Scheuermann's disease
  • Scheuermann kyphosis
  • Juvenile thoracic kyphosis
  • Scheuermann-Delahaye's disease
  • Vertebral epiphisitis
  • Kyphosis dorsalis juvenilis
  • Classical Scheuermann disease
  • Classic Scheuemann disease
  • Scheuermann's disease

Support Radiopaedia and see fewer ads

  • Drag
    Case 1: early stages before progressing to kyphosis
    Drag here to reorder.
  • Drag
    Case 2
    Drag here to reorder.
  • Drag
    Case 3
    Drag here to reorder.
  • Drag
    Case 4
    Drag here to reorder.
  • Drag
    Case 5
    Drag here to reorder.
  • Drag
    Case 6
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.