Juvenile Discogenic Disease

Also known as thoracolumbar Scheuermann's disease, this entity affects relatively young patients in their late teens to early 30s with low back pain referable to degenerative disc disease (25). Imaging reveals loss of intervertebral disc height, vertebral endplate irregularities and Schmorl's nodes at the thoracolumbar levels, associated with degenerative disc disease at the lower lumbar levels. Although its etiology is unclear, some have theorized an inherent defect of the disc and endplate leading to these premature degenerative changes (33). Others believe that excessive mechanical forces are to blame, as this disorder was almost an order of magnitude more common in children raised in the country (34,35).

Schmorl's nodes represent intradiscal herniations of nucleus pulposus through a disruption in the superior or inferior cartilaginous endplates (36). MRI usually demonstrates the nodes to be contiguous with the nucleus pulposus of origin and of the same signal intensity on both T1 and T2. However, in a minority of cases, the signal intensity can differ significantly (37).

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