55 year old man presents to the emergency department with severe bilateral flank pain, worse on movement. Nil previous spinal surgery, neurology or urinary symptoms. Previously fit and healthy.
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Abnormal enhancement and marrow signal in the T11 vertebral body with intact endplates. Calcific densities noted within the disc with herniation into the superior endplate of the T11 vertebra.
Given the clinical history, the findings are felt to represent a Schmorl node.
The patient had unremarkable bloods including a negative TB quantiferon assay. Normal CT abdomen / CT IVP and normal colonoscopy.
Repeat imaging and follow up:
There was an interval decrease in edema and enhancement within the T11 vertebral body between the initial MRI scan and one performed 3 months later. No other new abnormalities demonstrated. This strengthens the favored diagnosis of resolving inflammatory changes of a Schmorl node.