Back pain and oedematous Schmorl node: a diagnostic dilemma

Abstract

A 26-year-old female from India presented with progressive, unremitting low back pain for over 1 year. She had been treated unsuccessfully for left-sided sacroiliitis, pelvic floor dysfunction, ankylosing spondylitis and seronegative spondyloarthritis. MRI lumbar spine showed a Schmorl node with surrounding marrow oedema at L4, the relevance of which is not clear in literature. One year after initial presentation, a biopsy of this lesion revealed culture positive diagnosis of spinal tuberculosis. Despite advances in imaging, delayed diagnosis is not uncommon in spinal tuberculosis (TB). In our case, it was also attributed to an unknown early lesion: Schmorl node with surrounding oedema. Any association of this lesion with spinal TB has previously not been reported.

Infected Schmorl’s node: a case report

“…Many case reports have been found in literature regarding degenerative symptomatic SNs; However, we could not find any reference related to acute infected SN in the literature. One case reported of tuberculous spondylitis which created diagnostic dilemma with acute symptomatic SN which eventually treated with anti-tubercular drugs [23].…”