Scheuermann disease

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Scheuermann disease, also known as juvenile kyphosis, juvenile 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 radiograph.

Epidemiology

occurs in ~5% (range 0.4-8%) of the general population ²
typical age of presentation is between 12 and 17 years ¹³
slight male predominance

Pathology

Its exact etiology is unknown but a proposed mechanism is by osteonecrosis of the vertebral apophyseal rings. Excessive axial spine load due to heavy weightlifting 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.

Classification

type I: thoracic spine only
type II
- affecting the lower thoracic spine and lumbar spine
- some authors have proposed the term lumbar Scheuermann disease ^4,5 for a variant affecting the lumbar region

Radiographic features

To apply the label of classical Scheuermann disease, the Sorensen criteria need to be met ⁹:

thoracic spine kyphosis >40° (normal 25-40°) or
thoracolumbar spine kyphosis >30° (normal ~~~zero degrees~~~0°)

and

at least 3 adjacent vertebrae demonstrating wedging of >5°

Other signs include:

vertebral endplate irregularity due to extensive ~~disk~~disc invagination
intervertebral ~~disk~~disc space narrowing, more pronounced anteriorly

The condition is associated with

Treatment and prognosis

Management is largely dependent on the degree of kyphosis:

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

History and etymology

It is named after theDanish orthopedic surgeon and radiologist Holger Werfel Scheuermann (1877-1960)who first described it in 1920 as osteochondritis deformans juvenilis dorsi ^10,12.

-<p><strong>Scheuermann disease</strong>, also known as <strong>juvenile kyphosis</strong>, <strong>juvenile discogenic disease</strong> <sup>11</sup>, or <strong>vertebral epiphysitis</strong>, is a common condition which results in <a href="/articles/kyphosis">kyphosis</a> of the <a title="Thoracic spine" href="/articles/thoracic-spine">thoracic</a> or thoracolumbar spine. The diagnosis is usually made on plain radiograph.</p><h4>Epidemiology</h4><ul>
+<p><strong>Scheuermann disease</strong>, also known as <strong>juvenile kyphosis</strong>, <strong>juvenile discogenic disease</strong> <sup>11</sup>, or <strong>vertebral epiphysitis</strong>, is a common condition which results in <a href="/articles/kyphosis">kyphosis</a> of the <a href="/articles/thoracic-spine">thoracic</a> or thoracolumbar spine. The diagnosis is usually made on plain radiograph.</p><h4>Epidemiology</h4><ul>
-</ul><h4>Pathology</h4><p>Its exact etiology is unknown but a proposed mechanism is by <a title="Osteonecrosis" href="/articles/osteonecrosis-2">osteonecrosis</a> of the vertebral apophyseal rings. Excessive axial spine load due to heavy weightlifting may also contribute.</p><p>There is a strong hereditary predisposition (perhaps autosomal dominant) with a high degree of penetrance and variable expressivity.</p><h5>Location</h5><p>Occurs in the <a href="/articles/thoracic-spine">thoracic spine</a> in up to 75% of cases, followed by the thoracolumbar spine combined and occasionally <a href="/articles/lumbar-spine">lumbar</a> and rarely <a href="/articles/cervical-spine">cervical spine</a>. </p><h5>Classification</h5><ul>
+</ul><h4>Pathology</h4><p>Its exact etiology is unknown but a proposed mechanism is by <a href="/articles/osteonecrosis-2">osteonecrosis</a> of the vertebral apophyseal rings. Excessive axial spine load due to heavy weightlifting may also contribute.</p><p>There is a strong hereditary predisposition (perhaps autosomal dominant) with a high degree of penetrance and variable expressivity.</p><h5>Location</h5><p>Occurs in the <a href="/articles/thoracic-spine">thoracic spine</a> in up to 75% of cases, followed by the thoracolumbar spine combined and occasionally <a href="/articles/lumbar-spine">lumbar</a> and rarely <a href="/articles/cervical-spine">cervical spine</a>. </p><h5>Classification</h5><ul>
~~-<li>thoracolumbar spine kyphosis >30° (normal ~zero degrees)</li>~~
+<li>thoracolumbar spine kyphosis >30° (normal ~0°)</li>
~~-<li>vertebral endplate irregularity due to extensive disk invagination</li>~~
~~-<li>intervertebral disk space narrowing, more pronounced anteriorly</li>~~
+<li>vertebral endplate irregularity due to extensive disc invagination</li>
+<li>intervertebral disc space narrowing, more pronounced anteriorly</li>

References changed:

1. Summers B, Singh J, Manns R. The Radiological Reporting of Lumbar Scheuermann's Disease: An Unnecessary Source of Confusion Amongst Clinicians and Patients. Br J Radiol. 2008;81(965):383-5. <a href="https://doi.org/10.1259/bjr/69495299">doi:10.1259/bjr/69495299</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/18440942">Pubmed</a>
2. Ali R, Green D, Patel T. Scheuermann's Kyphosis. Curr Opin Pediatr. 1999;11(1):70-5. <a href="https://doi.org/10.1097/00008480-199902000-00014">doi:10.1097/00008480-199902000-00014</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/10084088">Pubmed</a>
3. Lowe T. Scheuermann Disease. J Bone Joint Surg Am. 1990;72(6):940-5. - <a href="https://www.ncbi.nlm.nih.gov/pubmed/2195036">Pubmed</a>
4. Gustavel M & Beals R. Scheuermann's Disease of the Lumbar Spine in Identical Twins. AJR Am J Roentgenol. 2002;179(4):1078-9. <a href="https://doi.org/10.2214/ajr.179.4.1791078">doi:10.2214/ajr.179.4.1791078</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/12239077">Pubmed</a>
5. Blumenthal S, Roach J, Herring J. Lumbar Scheuermann's. A Clinical Series and Classification. Spine (Phila Pa 1976). 1987;12(9):929-32. - <a href="https://www.ncbi.nlm.nih.gov/pubmed/3441839">Pubmed</a>
8. Summers B, Singh J, Manns R. The Radiological Reporting of Lumbar Scheuermann's Disease: An Unnecessary Source of Confusion Amongst Clinicians and Patients. Br J Radiol. 2008;81(965):383-5. <a href="https://doi.org/10.1259/bjr/69495299">doi:10.1259/bjr/69495299</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/18440942">Pubmed</a>
11. Heithoff K, Gundry C, Burton C, Winter R. Juvenile Discogenic Disease. Spine (Phila Pa 1976). 1994;19(3):335-40. <a href="https://doi.org/10.1097/00007632-199402000-00014">doi:10.1097/00007632-199402000-00014</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/8171367">Pubmed</a>
12. Rosendal T. Holger Werfel Scheuermann. Acta radiol. 1960;54(1):1-2. <a href="https://doi.org/10.3109/00016926009172519">doi:10.3109/00016926009172519</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/14438986">Pubmed</a>
13. Tomé-Bermejo F & Tsirikos A. [Current Concepts on Scheuermann Kyphosis: Clinical Presentation, Diagnosis and Controversies Around Treatment]. Rev Esp Cir Ortop Traumatol. 2012;56(6):491-505. <a href="https://doi.org/10.1016/j.recot.2012.07.002">doi:10.1016/j.recot.2012.07.002</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23594948">Pubmed</a>
1. Summers BN, Singh JP, Manns RA. The radiological reporting of lumbar Scheuermann's disease: an unnecessary source of confusion amongst clinicians and patients. Br J Radiol. 2008;81 (965): 383-5. <a href="http://dx.doi.org/10.1259/bjr/69495299">doi:10.1259/bjr/69495299</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/18440942">Pubmed citation</a><div class="ref_v2"></div>
2. Ali RM, Green DW, Patel TC. Scheuermann's kyphosis. Curr. Opin. Pediatr. 1999;11 (1): 70-5. <a href="http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1040-8703&volume=11&issue=1&spage=70">Curr. Opin. Pediatr. (link)</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/10084088">Pubmed citation</a><div class="ref_v2"></div>
3. Lowe TG. Scheuermann disease. J Bone Joint Surg Am. 1990;72 (6): 940-5. <a href="http://www.ejbjs.org/cgi/reprint/72/6/940.pdf">J Bone Joint Surg Am (pdf)</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/2195036">Pubmed citation</a><div class="ref_v2"></div>
4. Gustavel M, Beals RK. Scheuermann's disease of the lumbar spine in identical twins. AJR Am J Roentgenol. 2002;179 (4): 1078-9. <a href="http://www.ajronline.org/cgi/content/citation/179/4/1078">AJR Am J Roentgenol (citation)</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/12239077">Pubmed citation</a><div class="ref_v2"></div>
5. Blumenthal SL, Roach J, Herring JA. Lumbar Scheuermann's. A clinical series and classification. Spine. 1987;12 (9): 929-32. - <a href="http://www.ncbi.nlm.nih.gov/pubmed/3441839">Pubmed citation</a><div class="ref_v2"></div>
8. Summers BN, Singh JP, Manns RA. The radiological reporting of lumbar Scheuermann's disease: an unnecessary source of confusion amongst clinicians and patients. Br J Radiol. 2008;81 (965): 383-5. <a href="http://bjr.birjournals.org/content/81/965/383.full">Br J Radiol (full text)</a> - <a href="http://dx.doi.org/10.1259/bjr/69495299">doi:10.1259/bjr/69495299</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/18440942">Pubmed citation</a><span class="ref_v3"></span>
11. Heithoff KB, Gundry CR, Burton CV et-al. Juvenile discogenic disease. Spine. 1994;19 (3): 335-40. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8171367">Pubmed citation</a><span class="auto"></span>
12. ROSENDAL T. Holger Werfel Scheuermann. (1960) Acta radiologica. 54: 1-2. <a href="https://www.ncbi.nlm.nih.gov/pubmed/14438986">Pubmed</a> <span class="ref_v4"></span>
13. Tomé-Bermejo F, Tsirikos AI. [Current concepts on Scheuermann kyphosis: clinical presentation, diagnosis and controversies around treatment]. (2012) Revista espanola de cirugia ortopedica y traumatologia. 56 (6): 491-505. <a href="https://doi.org/10.1016/j.recot.2012.07.002">doi:10.1016/j.recot.2012.07.002</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23594948">Pubmed</a> <span class="ref_v4"></span>

Updates to Synonym Attributes

Title was changed:

Classic ~~Scheuemann~~Scheuermann disease

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