Giant fatty Schmorl node

Case contributed by Ammar Haouimi
Diagnosis probable

Presentation

Low back pain.

Patient Data

Age: 30 years
Gender: Male
ct
This study is a stack
Sagittal
non-contrast
This study is a stack
Axial
non-contrast
This study is a stack
Coronal
non-contrast
This study is a stack
Axial bone
window
This study is a stack
Sagittal
bone window
This study is a stack
Coronal
bone window
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Info

There is a well-defined intraosseous lesion of the L4 vertebral body of fatty density (mean density -62 HU) with sclerotic margin and small cortical interruption of the end-plate well-visualized on sagittal and coronal reformatted images. A small Schmorl node of the superior endplate of L3 is also noted.

The height of the vertebral bodies and disc spaces is preserved. No disc herniation is seen.

Annotated image
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Info

Annotated image showing the mean density of the intravertebral lesion (-62 HU).

Case Discussion

CT features of a well-defined intraosseous lesion of fatty density with a sclerotic peripheral rim of the L4 vertebral body with cortical interruption of the superior endplate suggestive of a giant fatty Schmorl node.

The main differential diagnosis is an intraosseous lipoma (usually the cortex of the vertebral endplates is intact).

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