Scheuermann's disease

*1. What is Scheuermann's disease (epiphysitis)?
2. What is the etiology of Scheuermann's disease?
3. What is the presentation of Scheuermann's disease?
*4. What is the diagnosis?
5. What is the treatment of Scheuermann's disease?

Answers:
1. D/o of vertebral endplates and apophysis, resulting in increased thoracic kyphosis, often seen in adolescents.
2. Failure of endochondral ossification --> intervertebral disc herniation, anterior wedging of vertebral bodies, fixed TL kyphosis.
3. Progressive nonpainful thoracic kyphosis that does not correct with hyperextension. Maybe also occur in young athletes.
4. X-ray shows Schmorl's nodes (herniation of disc material through vertebral endplate into vertebral body), irregular endplates, spondylosis, scoliosis, vertebral wedging.
5. Rehab involves thoracic extension and abdominal strengthening, bracing if kyphosis <74>75 or >65 in skeletally immature.