Scheuermann's Disease
Scheuermann's Disease is a progressive thoracic kyphosis in the adolescent.
Demographics
Most commonly affects adolescent boys. The exact cause of the disease is unknown but is thought to have a genetic component.
Clinical Presentation
• Increased thoracic kyphosis, especially T7 to T10
• Kyphosis does not change with prone extension
• Compensatory hyperlordosis
• Tight hamstrings and pectoral muscles
• Apical pain
• Pain in the middle or low back
• Parental complaint about their child's poor posture
• Minimal structural scoliosis may be present in 1/3 patients
Differential Diagnosis
• Imaging: vertebral wedging, Schmorl’s nodes, endplate irregularity, disc space narrowing
• More than 5 degrees of wedging in three or more adjacent vertebrate fulfill diagnostic criteria for Scheuermann's Disease
Clinical Bottom Line: Treat and Refer
A referral is necessary to obtain imaging. Treatment should include educating the patient about joint protection and maintaining mobility of the spine as well as exercises to increase or maintain range of motion, improve posture, and strengthen trunk musculature.
References:
Please refer to the "Scheuermann's Disease" section of the reference list.
Demographics
Most commonly affects adolescent boys. The exact cause of the disease is unknown but is thought to have a genetic component.
Clinical Presentation
• Increased thoracic kyphosis, especially T7 to T10
• Kyphosis does not change with prone extension
• Compensatory hyperlordosis
• Tight hamstrings and pectoral muscles
• Apical pain
• Pain in the middle or low back
• Parental complaint about their child's poor posture
• Minimal structural scoliosis may be present in 1/3 patients
Differential Diagnosis
• Imaging: vertebral wedging, Schmorl’s nodes, endplate irregularity, disc space narrowing
• More than 5 degrees of wedging in three or more adjacent vertebrate fulfill diagnostic criteria for Scheuermann's Disease
Clinical Bottom Line: Treat and Refer
A referral is necessary to obtain imaging. Treatment should include educating the patient about joint protection and maintaining mobility of the spine as well as exercises to increase or maintain range of motion, improve posture, and strengthen trunk musculature.
References:
Please refer to the "Scheuermann's Disease" section of the reference list.