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SCHMORL’S NODE ON SPINE MRI: ACUTE & CHRONIC SCHMORL’S NODES MRI

The Dx

/ Spine Degeneration

MRI ACUTE AND CHRONIC SCHMORL'S NODES

This post highlights the key imaging appearances of acute and chronic Schmorl’s nodes on spine MRI.

SCHMORL'S NODES ON SPINE MRI

ACUTE SCHMORL'S NODE MRI

Acute Schmorl’s nodes demonstrate oedema at their margins. This is usually limited to around the circumference of the margins but occasionally can be very extensive.

CHRONIC SCHMORL'S NODE: PART 1

Chronic Schmorl’s nodes can have a variable appearance. Here the margin is corticated and the marrow signal at the margins of the schmorl’s node is normal with no oedema or fatty change.

CHRONIC SCHMORL'S NODE: PART 2

The second appearance of chronic Schmorl’s nodes is for the marrow around the margin to have fatty infiltration, with fat signal more than in the adjacent marrow.

Read Article: “Differentiation of Schmorl’s Nodes from Bone Metastases of the Spine“, Read HERE

TEST YOURSELF ON SOME COMMON & FREQUENTLY ASKED QUESTIONS

WHAT DO ACUTE SCHMORL’S NODES LOOK LIKE ON MRI?

Acute Schmorl’s nodes typically show oedema at their margins. This oedema is usually confined around the circumference of the node, though in some cases, it may extend more extensively into the surrounding marrow.

HOW CAN CHRONIC SCHMORL’S NODES BE IDENTIFIED ON MRI?

Chronic Schmorl’s nodes can present in two forms: some have corticated margins with normal marrow signal and no associated oedema or fatty change; others show fatty infiltration at the node’s margins, which appears as increased fat signal compared to the adjacent marrow.

WHAT CAUSES THE MARROW SIGNAL CHANGES SEEN AROUND SCHMORL’S NODES?

The signal changes—whether oedema in acute cases or fatty infiltration in chronic ones—represent reactive bone marrow changes. These occur in response to disc material herniating into the vertebral body, which triggers inflammation or fat replacement depending on the chronicity.

We look at all of these topics in more detail in our Guided SPINE & SIJ Imaging Mini Fellowships.

Click on the image below for more information.