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December 2004
By Theodore E. Keats, MD
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A 20-year-old wrestler complains of lumbar back pain.
What is your interpretation of this lateral projection
of his lumbar spine?
CLICK HERE FOR ANSWER
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ANSWER
The correct answer is Schmorl's nodes. The anterior
defect of L1 in this patient is a limbus vertebra, and
that of L2 is a classic Schmorl's node. The limbus vertebra
is the result of anterior protrusion of the intervertebral
disk beneath the ring apophysis of the growing vertebral
body, which prevents union of the two structures. The
Schmorl's node is the product of intrabody herniation
of the nucleus pulposus. Neither of these entities is
a likely cause of the patient's pain.
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This series of diagnostic quizzes that
challenge your ability to read a variety of X-ray films is
edited by Dr. Keats, alumni professor of radiology at the
University of Virginia School of Medicine in Charlottesville.
Emerg Med 36(12):57, 2004
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