Acute Schmörl node
Active, sports loving child with 3 weeks of back pain. Otherwise well with normal CRP and white cell count. No fever.
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Herniation of disc material into the superior endplate of L1 with marked surrounding bone marrow oedema but no involvement of the T12 endplate and no disc desiccation or oedema.
Major differential in this case is endplate osteomyelitis but no T12 involvement. L1 endplate cortex otherwise intact. Follow-up after 12 weeks of rest (no sport) showed dramatic resolution of the bone marrow oedema.
- Fahey V, et al. The pathogenesis of Schmorl's nodes in reaction to acute trauma. An autopsy study. Spine 1998;23(21):2272-5.