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Mark E. Schweitzer - One of the best experts on this subject based on the ideXlab platform.

  • Edematous Schmorl’s Nodes on thoracolumbar MR imaging: characteristic patterns and changes over time
    Skeletal Radiology, 2006
    Co-Authors: William B. Morrison, Mark E. Schweitzer
    Abstract:

    Objective To describe the patterns and note the evolution of edematous Schmorl’s Nodes. Materials and methods In 47 patients (M:F=26:21, 24–86 years, average 60), 84 Schmorls Nodes with T2 hyperintensity with serial MR exams were evaluated. Interval between MR exams was 2–72 months (average 17). Two observers noted size, location, margins, internal and surrounding T1/T2 signal, adjacent disc herniation or bulge, concentric ring, underlying fracture, malignancy, infection, or prior disc surgery, and serial MR changes in these characteristics over time. Results Node size averaged 7×9 mm. Most were located at L3 (29%, 24/84), L4 (19%, 16/84) and L2 (13%, 11/84), at the central (39%, 33/84) or outer (30%, 25/84) third of the endplate. 55% (39/71) had a bulging disc, 7% (5/71) had disc herniation. 10% (8/84) had evidence of associated fracture, 17% (14/84) tumor, 7% (6/84) infection. Most Nodes had well-defined margins (82%, 69/84). The most common node internal signal was isointense to adjacent disc on T1/T2 (33%, 28/84); surrounding marrow was most commonly hypointense on T1 and hyperintense on T2 (54%, 38/71). A common finding was concentric rings (38%, 32/84) in the marrow surrounding the node, a finding which had 72% negative predictive value for absence of infection, tumor and fracture. On follow-up, there was no interval change in node size in 46%(39/84) of Schmorl’s Nodes. 26% (22/84) had increased size. Most (60%, 50/84) showed no temporal change in internal T2 signal. 21% (18/84) of Nodes showed decreased internal T2 signal, 13% (11/84) showed increased T2 signal. Regarding the surrounding marrow, most (58%, 49/84) showed no temporal change in T2 signal; 21%(18/84) showed decreased T2 signal, 13% (11/84) showed increased T2 signal. In 13 Schmorl’s Nodes with intranodal enhancement, eight (62%) showed no interval change; among eight with enhancement in surrounding marrow, five (63%) showed no change on follow-up. Conclusion Although most remain unchanged, a relatively large minority of edematous Schmorl's Nodes evolve in size and signal over a relatively short time. Some evolve to form well-defined concentric rings in the surrounding marrow that appear to be analogous to degenerative changes of endplates. Concentric ring formation has a high negative predictive value for “idiopathic” Schmorl’s Nodes without underlying fracture, infection, or malignancy.

  • Edematous Schmorl's Nodes on thoracolumbar MR imaging: characteristic patterns and changes over time.
    Skeletal radiology, 2006
    Co-Authors: William B. Morrison, Mark E. Schweitzer
    Abstract:

    To describe the patterns and note the evolution of edematous Schmorl’s Nodes. In 47 patients (M:F=26:21, 24–86 years, average 60), 84 Schmorls Nodes with T2 hyperintensity with serial MR exams were evaluated. Interval between MR exams was 2–72 months (average 17). Two observers noted size, location, margins, internal and surrounding T1/T2 signal, adjacent disc herniation or bulge, concentric ring, underlying fracture, malignancy, infection, or prior disc surgery, and serial MR changes in these characteristics over time. Node size averaged 7×9 mm. Most were located at L3 (29%, 24/84), L4 (19%, 16/84) and L2 (13%, 11/84), at the central (39%, 33/84) or outer (30%, 25/84) third of the endplate. 55% (39/71) had a bulging disc, 7% (5/71) had disc herniation. 10% (8/84) had evidence of associated fracture, 17% (14/84) tumor, 7% (6/84) infection. Most Nodes had well-defined margins (82%, 69/84). The most common node internal signal was isointense to adjacent disc on T1/T2 (33%, 28/84); surrounding marrow was most commonly hypointense on T1 and hyperintense on T2 (54%, 38/71). A common finding was concentric rings (38%, 32/84) in the marrow surrounding the node, a finding which had 72% negative predictive value for absence of infection, tumor and fracture. On follow-up, there was no interval change in node size in 46%(39/84) of Schmorl’s Nodes. 26% (22/84) had increased size. Most (60%, 50/84) showed no temporal change in internal T2 signal. 21% (18/84) of Nodes showed decreased internal T2 signal, 13% (11/84) showed increased T2 signal. Regarding the surrounding marrow, most (58%, 49/84) showed no temporal change in T2 signal; 21%(18/84) showed decreased T2 signal, 13% (11/84) showed increased T2 signal. In 13 Schmorl’s Nodes with intranodal enhancement, eight (62%) showed no interval change; among eight with enhancement in surrounding marrow, five (63%) showed no change on follow-up. Although most remain unchanged, a relatively large minority of edematous Schmorl's Nodes evolve in size and signal over a relatively short time. Some evolve to form well-defined concentric rings in the surrounding marrow that appear to be analogous to degenerative changes of endplates. Concentric ring formation has a high negative predictive value for “idiopathic” Schmorl’s Nodes without underlying fracture, infection, or malignancy.

William B. Morrison - One of the best experts on this subject based on the ideXlab platform.

  • Edematous Schmorl’s Nodes on thoracolumbar MR imaging: characteristic patterns and changes over time
    Skeletal Radiology, 2006
    Co-Authors: William B. Morrison, Mark E. Schweitzer
    Abstract:

    Objective To describe the patterns and note the evolution of edematous Schmorl’s Nodes. Materials and methods In 47 patients (M:F=26:21, 24–86 years, average 60), 84 Schmorls Nodes with T2 hyperintensity with serial MR exams were evaluated. Interval between MR exams was 2–72 months (average 17). Two observers noted size, location, margins, internal and surrounding T1/T2 signal, adjacent disc herniation or bulge, concentric ring, underlying fracture, malignancy, infection, or prior disc surgery, and serial MR changes in these characteristics over time. Results Node size averaged 7×9 mm. Most were located at L3 (29%, 24/84), L4 (19%, 16/84) and L2 (13%, 11/84), at the central (39%, 33/84) or outer (30%, 25/84) third of the endplate. 55% (39/71) had a bulging disc, 7% (5/71) had disc herniation. 10% (8/84) had evidence of associated fracture, 17% (14/84) tumor, 7% (6/84) infection. Most Nodes had well-defined margins (82%, 69/84). The most common node internal signal was isointense to adjacent disc on T1/T2 (33%, 28/84); surrounding marrow was most commonly hypointense on T1 and hyperintense on T2 (54%, 38/71). A common finding was concentric rings (38%, 32/84) in the marrow surrounding the node, a finding which had 72% negative predictive value for absence of infection, tumor and fracture. On follow-up, there was no interval change in node size in 46%(39/84) of Schmorl’s Nodes. 26% (22/84) had increased size. Most (60%, 50/84) showed no temporal change in internal T2 signal. 21% (18/84) of Nodes showed decreased internal T2 signal, 13% (11/84) showed increased T2 signal. Regarding the surrounding marrow, most (58%, 49/84) showed no temporal change in T2 signal; 21%(18/84) showed decreased T2 signal, 13% (11/84) showed increased T2 signal. In 13 Schmorl’s Nodes with intranodal enhancement, eight (62%) showed no interval change; among eight with enhancement in surrounding marrow, five (63%) showed no change on follow-up. Conclusion Although most remain unchanged, a relatively large minority of edematous Schmorl's Nodes evolve in size and signal over a relatively short time. Some evolve to form well-defined concentric rings in the surrounding marrow that appear to be analogous to degenerative changes of endplates. Concentric ring formation has a high negative predictive value for “idiopathic” Schmorl’s Nodes without underlying fracture, infection, or malignancy.

  • Edematous Schmorl's Nodes on thoracolumbar MR imaging: characteristic patterns and changes over time.
    Skeletal radiology, 2006
    Co-Authors: William B. Morrison, Mark E. Schweitzer
    Abstract:

    To describe the patterns and note the evolution of edematous Schmorl’s Nodes. In 47 patients (M:F=26:21, 24–86 years, average 60), 84 Schmorls Nodes with T2 hyperintensity with serial MR exams were evaluated. Interval between MR exams was 2–72 months (average 17). Two observers noted size, location, margins, internal and surrounding T1/T2 signal, adjacent disc herniation or bulge, concentric ring, underlying fracture, malignancy, infection, or prior disc surgery, and serial MR changes in these characteristics over time. Node size averaged 7×9 mm. Most were located at L3 (29%, 24/84), L4 (19%, 16/84) and L2 (13%, 11/84), at the central (39%, 33/84) or outer (30%, 25/84) third of the endplate. 55% (39/71) had a bulging disc, 7% (5/71) had disc herniation. 10% (8/84) had evidence of associated fracture, 17% (14/84) tumor, 7% (6/84) infection. Most Nodes had well-defined margins (82%, 69/84). The most common node internal signal was isointense to adjacent disc on T1/T2 (33%, 28/84); surrounding marrow was most commonly hypointense on T1 and hyperintense on T2 (54%, 38/71). A common finding was concentric rings (38%, 32/84) in the marrow surrounding the node, a finding which had 72% negative predictive value for absence of infection, tumor and fracture. On follow-up, there was no interval change in node size in 46%(39/84) of Schmorl’s Nodes. 26% (22/84) had increased size. Most (60%, 50/84) showed no temporal change in internal T2 signal. 21% (18/84) of Nodes showed decreased internal T2 signal, 13% (11/84) showed increased T2 signal. Regarding the surrounding marrow, most (58%, 49/84) showed no temporal change in T2 signal; 21%(18/84) showed decreased T2 signal, 13% (11/84) showed increased T2 signal. In 13 Schmorl’s Nodes with intranodal enhancement, eight (62%) showed no interval change; among eight with enhancement in surrounding marrow, five (63%) showed no change on follow-up. Although most remain unchanged, a relatively large minority of edematous Schmorl's Nodes evolve in size and signal over a relatively short time. Some evolve to form well-defined concentric rings in the surrounding marrow that appear to be analogous to degenerative changes of endplates. Concentric ring formation has a high negative predictive value for “idiopathic” Schmorl’s Nodes without underlying fracture, infection, or malignancy.

Bárány Mia - One of the best experts on this subject based on the ideXlab platform.

  • The health of the doomed : A study of the executed’s health from two executional sites on Gotland.
    Uppsala universitet Institutionen för arkeologi och antik historia, 2019
    Co-Authors: Bárány Mia
    Abstract:

    This bachelor thesis covers two executional sites on the island of Gotland with focus on the palaepathology among the executed individuals. The aim is to see which pathological changes that occured most often and if they have any correlation between these and these individuals socioeconomic status. To achieve this the author has examined the bones from Galgberget to identify apparent pathological changes on long bones, vertebrates, maxillaries and mandibles. I have also compared the bones from Galgberget with previous analyses from the other executional site in Grötlingbo parish. The most common pathological change that became identified were osteophytes, arthritis and a couple of oral pathologies like calculus and cavities. Osteophytes and arthritis do share a comparability since they both are derived from osteoarthritis which is a denegerative joint disease. Calculus and cavities also share smiliarities, due to the fact that cavities is the first stage before it becomes calculus. No other pathological similarities were found among the two sites. Although the appearances of Schmorl’s Nodes were significantly large among the bone assembly from Galgberget. Schmorl’s Nodes is a vertebral lesion that may occur in all ages and have different causes. Other common pathological changes identified from Galgberget were skeletal anomalies and enthesopathies. Smiliar to Schmorls Nodes, enthesopathy have different causes and often show in a relation to heavy physical work. It can be concluded that the presence of Schmorl’s Nodes, skeletal anomalies, enthesopathy and osteophytes do share an equivalence with each other, when you think about how you get these pathological changes in life. With further studies regarding the material from Galgberget, the view of the people who were executed there may have a real potential to change

Kassim, Ahmad Fauzey - One of the best experts on this subject based on the ideXlab platform.

  • Changes in adolescent intervertebral discs, end plates and bone marrow of lumbar spine in idiopathic thoracic scoliosis an mri based study
    2010
    Co-Authors: Kassim, Ahmad Fauzey
    Abstract:

    Intervertebral disc degeneration is known to occur as early as the first decade in normal individuals. In adolescent idiopathic thoracic scoliosis, the spinal curvature is thought to impart mechanical stresses on the lumbar spine. This in theory would lead to early degenerative discs changes, Modic changes and Schmorl’s Nodes as part of the whole degenerative process. Before the advent of magnetic resonance imaging (MRI), proper assessment of the discs, end plates, vertebral bone marrow changes and Schmorl’s Nodes were not possible. With the help of MRI, a more detailed and accurate assessment of the intervertebral disc and vertebral bone marrow is now possible. This was a cross sectional study with the aim to identify and grade lumbar intervertebral discs, end plates, bone marrow changes and Schmorl’s Nodes in adolescent idiopathic thoracic scoliosis patients. Lumbar MRI films from 40 patients totaling 200 discs were recruited into this study during 6 month period. The patients’ ages were 15.5 ± 2.7 years old ( range 10 to 20). The Cobb’s angles average were 47.63° ± 14.1° (range 20° to 80°). The patients were those attending Spine clinic, Hospital Universiti Sains Malaysia and diagnosed with idiopathic thoracic scoliosis. MRI were ordered for them mainly due to complaints of back pain, neurological deficit and others. MRI films were obtained from the online database system and analyzed by a radiologist, looking for the changes mentioned before. Thoracic scoliosis Cobb’s angles were measured from patient’s AP(anteroposterior) radiological film of the spine. Demographic data regarding sex and age were obtained from the patients’ medical records. Our results showed that in adolescent idiopathic thoracic scoliosis patients, all lumbar discs were affected by degenerative changes mainly grade 2 and 3 in Pfirrmann classification system. No disc 6 was graded as normal (Pfirrmann 1). Modic changes(15%) and Schmorl’s Nodes(5%) are not commonly found in the lumbar discs of idiopathic thoracic scoliosis. The severity of thoracic spinal curvature was not proven to affect grades (Pfirrmann) of degenerative disc changes, Modic changes and Schmorls Nodes. (all p value >0.05) We concluded that lumbar discs in adolescent idiopathic scoliosis with a single thoracic curve are all affected by degenerative changes. The thoracic curvature was not proven to have a direct effect on the severity of disc changes, Modic changes and Schmorl’s Nodes. Keyword: idiopathic scoliosis; intervertebral discs; Modic changes; Schmorl’s Nodes; thoracic curvatur

H. Rovsing - One of the best experts on this subject based on the ideXlab platform.

  • SCHMORL Nodes: AN EPIDEMIOLOGICAL PERSPECTIVE.
    2009
    Co-Authors: S. Sonne-holm, S. Jacobsen, T. Jensen, L. Hyldstrup, H. Rovsing
    Abstract:

    Background: The epidemiology of Schmorl Nodes is based on post-mortem investigations. The proposed pathogenesis of the focal Nodes is a bulging of the disc into the vertebral body depending of the degree of osteoporosis. Secondar peripheral osteophytes are formed at the annular insertion. Study design: A cross sectional epidemiological study of 4151 participants of the Copenhagen Osteoarthritis Study in 1993 with a 13 years follow with the Roland-Morris (R-MQ) back pain questionnaire. In 1993 standardized, lateral radiographs of the lumbar spine were recorded and the bone mineral density (BMD) was estimated by digital x-ray radiogrammetry of standardised hand x-rays. Methods: Statistical correlations were made between Schmorl Nodes and low back pain in 1993, the R-MQ score, BMD and the presence of osteophytes, disc degeneration and endplate sclerosis. Results: There were 2610 women and 1538 men. At follow up 1190 women and 674 responded. In 196 cases one or more Schmorl Nodes in the lumbar spine were found (women 3.7 %, men 6.5 %). A decreasing prevalence of Schmorl Nodes by ages was found in both genders (p 0.14) in 1993. Neither was the R-MQ score at follow-up related to Schmorls Nodes(p>0.26). The presence of Nodes was associated with higher BMD (mean 0.50 (SD 0.079) versus 0.53 (SD 0.081)(p=0.000), however the difference disappeared taking into account age at examination. Conclusion: This large scaled epidemiological study cannot confirm the hitherto hold opinion of the implication of the Schmorls Nodes. The Nodes are not associated with radiological degeneration and osteoporosis neither are they a predictor of lower back pain later in life.