Schmorl’s cartilage nodules are pathological changes in the spine. The intervertebral discs are primarily affected by the deformations. As part of the disease, the tissue of the intervertebral discs shifts so that it gets into the vertebral bodies.
What are Schmorl’s cartilage nodules?
In connection with the development of Schmorl’s cartilage nodules, there is a so-called herniation of tissue of the intervertebral discs into the body of the individual vertebrae. The disease was first described by Christian Georg Schmorl. The phenomenon was named Schmorl’s cartilage nodules in honor of the doctor. See biotionary for What does MP stand for.
In the English-speaking world, the disease is referred to as ‘Schmorl’s nodes’ in the majority of cases. In principle, Schmorl’s cartilage nodules are components of the tissue of the intervertebral discs. This tissue penetrates the plates of the vertebrae, both superior and inferior. The weight of the spine rests on the vertebral bodies.
The tissue of the intervertebral discs penetrating the vertebral bodies shows increasing calcification and cartilage as the disease progresses. In addition, Schmorl’s cartilage nodules are a characteristic symptom of Scheuermann’s disease. As part of this disease, disorders in the growth of the spine appear in the affected patients during the puberty phase.
Causes
Schmorl cartilage nodules form as a result of various factors. Possible causes for the genesis of the disease are, for example, disturbances in growth processes in the area of the vertebral bodies. In addition, traumatic influences can also trigger Schmorl’s cartilage nodules, for example in connection with injuries or accidents.
If impairments of the usual growth processes are the reason for the formation of Schmorl’s cartilage nodules, then in most cases the end plates of the vertebrae are affected. These endplates are mostly made of cartilage. Injuries to the endplates are also the first step in accidents or trauma that result in Schmorl’s cartilage nodules.
In addition, in numerous cases, patients with Scheuermann’s disease also suffer from Schmorl’s cartilage nodules at the same time. The typical tissue displacement of the intervertebral discs usually results from gaps in the upper plates of the vertebral bodies. Such gaps either exist from birth or have been acquired through various influencing factors.
Symptoms, Ailments & Signs
If people suffer from Schmorl’s cartilage nodules, various symptoms appear. The nodules appear as dents in the endplates of the bodies of the vertebrae. As a rule, both the lower base plates and the upper cover plates are affected by the Schmorl cartilage nodules. The dents are weaker or more pronounced and range from small depressions to ball-like indentations.
As a result of these dents, it is possible that a narrowing of the intervertebral discs will develop. Such deformations are relatively clearly visible in X- ray examinations due to characteristic flattening in the so-called compartment of the intervertebral discs. The endplate of the vertebral body that lies on the other side of Schmorl’s cartilage nodule may show an overgrowth.
Doctors also refer to this phenomenon as the so-called Edgren-Vaino sign. At the beginning of the disease, there is only a displacement of tissue. This disc tissue calcifies over time and forms cartilage.
Diagnosis & course of disease
The doctor begins the diagnosis of Schmorl’s cartilage nodules with the obligatory patient consultation or anamnesis. He fathoms the signs of illness and symptoms as well as the lifestyle and possible disease-promoting factors for the development of Schmorl’s cartilage nodules. Any trauma that may have occurred in the area of the spine is particularly relevant.
After talking to the patient, the treating doctor uses different methods of examination. First, the person usually has to undergo an X-ray examination. This imaging procedure usually gives the first indication of the presence of Schmorl’s cartilage nodules. In addition, an MRI examination is often carried out, since the Schmorl cartilage nodules can be shown more clearly here than with an X-ray.
The typical indentations in the endplates on the vertebrae are visible during the imaging examination procedures. The intervertebral disc space is significantly flatter than usual and indicates the Schmorl cartilage nodules. Scheuermann’s disease can also be diagnosed in this way. The doctor treating you must always carry out a differential diagnosis.
The Schmorl cartilage nodules are distinguished from other potential diseases, some of which impress with similar symptoms. For example, the doctor checks whether the patient has chorda dorsalis regression disorders or pathological abnormalities following spondylodiscitis. The Edgren-Vaino sign, which shows up in Schmorl’s cartilage nodules in imaging procedures and facilitates differentiation from other diseases, is helpful in the differential diagnosis.
Complications
Due to the Schmorl cartilage nodules, those affected primarily suffer from the formation of small nodules and swellings that occur in the area of the back and spine. The Schmorl cartilage nodules do not always lead to symptoms, so that treatment is not always necessary.
However, due to the disease, the intervertebral disc can become narrower, which can lead to pain or restricted movement. Those affected often suffer from overgrowth. Especially in children, the overgrowth can lead to bullying or teasing. As a result, many patients also suffer from depression or mental health problems. Furthermore, the tissue of the intervertebral discs can calcify or form cartilage as the disease progresses.
As a rule, there are no special complications in the treatment of Schmorl’s cartilage nodules. The symptoms can be reduced with the help of various therapies or physiotherapy. Surgical interventions are also rarely necessary for the disease. However, the sufferer should be aware that taking painkillers over a long period of time can damage the stomach. However, the life expectancy of those affected is not negatively affected by the Schmorl cartilage nodules.
When should you go to the doctor?
A Schmorl cartilage nodule should always be treated by a doctor. As a rule, this disease cannot heal itself, so that the affected person is dependent on a visit to a doctor in any case. The earlier the Schmorl cartilage nodules are detected, the better the further course of this disease. A doctor should be consulted if the patient develops small nodules and dents on the vertebral bodies in the back.
In most cases, these dents are noticeable and so pronounced that they can also be seen with the naked eye. Furthermore, restrictions in movement or severe pain in the back can indicate Schmorl’s cartilage nodules and should be examined by a doctor. It is not uncommon for an overgrowth to indicate this complaint and must also be checked by a doctor. Parents, in particular, must have their children examined by a doctor. The treatment and diagnosis of the disease can usually be carried out by an orthopedist.
Treatment & Therapy
Whether treatment of Schmorl’s cartilage nodules is necessary depends on the extent of the symptoms and the accompanying circumstances. If the Schmorl cartilage nodules occur in connection with Scheuermann’s disease, therapeutic measures must also be considered. In some patients, regular physical therapy relieves the symptoms of the disease.
In the case of Schmorl’s cartilage nodules with Scheuermann’s disease, it is sometimes necessary for the affected patients to wear a corset to stabilize and support the spine. If the affected person suffers from pain, appropriate painkillers are used. Only rarely are surgical interventions necessary to treat Schmorl’s cartilage nodules and Scheuermann’s disease.
Prevention
Prevention of Schmorl cartilage nodules tends to be difficult. Sufficient physical activity is always helpful to strengthen the muscles of the entire body and especially the spine. In this way, some trauma to the vertebral bodies can be cushioned.
Aftercare
There are different courses of the disease in Schmorl’s cartilage nodules. Some of the patients remain symptom-free and do not perceive any pain in the spine. In others, the nodules swell or become stiff. A symptom-free course requires no further treatment. Follow-up care is useless. The patient can still undergo a medical check-up after an examination reveals Schmorl nodes.
The doctor can recognize and treat a possible deterioration of the condition in good time. If the lumps are associated with pain or limited mobility, follow-up care is advisable. The aim is to avoid consequential damage to the affected area of the spine and to alleviate symptoms.
In the case of drug-based pain therapy, tolerability must be checked afterward. The medication must not be taken longer than prescribed by the doctor. With the help of physiotherapeutic treatment, the mobility of the spine is maintained. If an operation has been performed, the orthopedist will check the healing process.
The general practitioner continues the follow-up care after the patient has been discharged. It ends when the spine is resilient again. Affected children are often taller than their peers. The consequences can be bullying and insensitive behavior on the part of peers. Psychotherapy can help prevent depression. The aim is to stabilize the patient’s self-confidence.
You can do that yourself
In the case of Schmorl’s cartilage nodules, the possibilities for self-help are aimed at reducing possible risk factors and improving well-being. In order to reduce existing complaints or malformations in the growth process, physical stress should be avoided. Sports activities and daily movements should be geared to the possibilities of the organism. If the first irregularities occur, rest periods and adequate rest are important.
In order to give the body enough time to regenerate, sleep hygiene should be optimized. For a restful sleep, the room temperature, sleeping utensils and lighting conditions must be adjusted to the natural needs of the human being. Background noise and interruptions to sleep at night should be avoided.
Cognitive training or alternative healing methods can be used to reduce prescribed pain medication. Patients report that they often experience less pain when they use the methods of hypnosis, autogenic training, or meditation on a regular basis. Many techniques can be used independently as needed.
It is advisable to wear good shoes to provide sufficient relief for the skeletal system. High heels on the shoes should be avoided and the size of the shoes should be adjusted to the foot size. This can reduce gait insecurity, poor posture or problems with locomotion. If muscular problems occur, massages or heat treatments should be carried out.
