LUMBAR/TYPE TWO SCHEUERMANN’S DISEASE, A RADIOLOGICALLY BASED CONDITION COMMONLY REPORTED BY RADIOLOGISTS AND WHICH MIGHT BE BETTER IGNORED.

Abstract

The purpose of the study was, to investigate how often the diagnosis of “Scheuermann’s disease” was made in radiological reports to General Practitioners, to determine the precise nature of the disease being described, and to evaluate the management of patients by GP’s who receive such radiological reports.

A computerised search of radiological reports to local GP’s revealed fifty reports over a two and a half period which included the diagnosis of “Scheuermann’s disease”. Assessment of these radiographs by a Consultant Radiologist indicated that ten of these patients had classical Scheuermann’s (abnormal thoracic kyphosis associated with disc and end plate irregularities), and forty had so called lumbar/type two Scheuermann’s (disc and end plate irregularities of the thoraco lumbar spine without deformity).

A questionnaire was sent out to GP’s which consisted a case history of a middle aged patient with typical symptoms of degenerative low back pain without deformity, including a radiological report indicating the “possibility of Scheuermann’s disease”, on the basis of features typical of Scheuermann’s lumbar/type two.

86% of GP’s indicated that they would inform their patients that they had “Scheuermann’s disease” using that term, but 48% did not appreciate the meaning of the term in the context of the case history.

We conclude that the majority of radiological reports to GP’s which include the diagnosis “Scheuermann’s disease” relate to lumbar/type two Scheuermann’s, and that the nature of the radiological diagnosis, invariably passed on to the patient, is often misunderstood by the GP. This may well result in patients presenting to spinal clinicians with unnecessary anxiety due to concerns of possible serious pathology.

We would recommend that spinal clinicians encourage their radiological colleagues to avoid the use of the words “Scheuermann’s disease” in radiological reports to GP’s except when describing classical adolescent thoracic kyphosis.