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Orthopaedics Avascular Necrosis & Osteochondroses cd94f630

Scheuermann's disease is:

A
Osteochondritis of calcaneum
B
Osteochondritis of navicular
C
Verteral Osteochondritis
D
Osteochondritis of scaphoid
High-Yield Explanation
Ans. C. Verteral Osteochondritis. (Ref. Fundamentals of Pediatric Orthopedics /pg. 17).Scheuermann's disease refers to osteochondrosis of the secondary ossification centers of the vertebral bodies. The lower dorsal and upper lumbar vertebrae are involved initially. The process may be limited to several bodies or may involve the entire dorsal and lumbar spine.Osteochondritis of the upper and lower cartilaginous vertebral plates has been incriminated in the development of Scheuermann's disease. A definite hereditary component is involved in the development of the condition, but the mode of inheritance has been debated.Patients with Scheuermann's disease generally are affected at age 13-16 years,Scheuermann's disease affects boys more frequently than it does girls.Sorenson suggested the following radiologic criteria for the diagnosis of Scheuermann's disease:# Hyperkyphosis greater than 40deg# Irregular upper and lower vertebral endplates with loss of disk space height# Wedging of 5deg or more in 3 consecutive vertebraeLateral radiograph of the spine demonstrates diagnostic changes in Scheuermann's disease.# Wedge-shaped vertebral bodies# Arcuate and rigid kyphosis# Narrow intervertebral disk spaces with calcifications# Prominent irregularities of the vertebral surfaces# Vertebral plates that are poorly formed and that develop multiple herniations of the nucleus pulposus known as Schmorl nodes (Note that Schmorl nodes are not uncommon and may be seen in Wilson disease, sickle cell anemia, and spinal stenosis.)# Patients with mild, nonprogressive disease can be treated by reducing weight-bearing stress and avoiding strenuous activity. Exercise alone is not found to be beneficial.# When the kyphosis is more severe, recommendations include casting, a spinal brace, or rest and recumbency on a rigid bed. Orthotic management of Scheuermann's disease usually requires 12-24 months of treatment. Surgery rarely is indicated in patients with Scheuermann's disease. Probably the 2 most common indications for surgery are spinal pain and unacceptable cosmetic appearance.

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