Dysmorphic Vertebral Body
Julia Crim, MD
DIFFERENTIAL DIAGNOSIS
Common
Single Vertebral Body
Post-Traumatic Deformity
Schmorl Node
Limbus Vertebra
Lytic Osseous Metastases
Multiple but not all Vertebral Bodies
Abnormal Segmentation
Partial Vertebral Duplication
Vertebral Segmentation Failure
Klippel-Feil Spectrum
Scheuermann Disease
Scoliosis
Lytic Osseous Metastases
Juvenile Idiopathic Arthritis
Neurogenic (Charcot) Arthropathy
Post-Radiation Changes
Diffusely Abnormal Vertebral Bodies
Sickle Cell
Osteogenesis Imperfecta
Achondroplasia
Less Common
Single Vertebral Body
Kümmell Disease
Osteochondroma
Ewing Sarcoma
Langerhans Cell Histiocytosis
Multiple Vertebral Bodies
Pyogenic Osteomyelitis
Granulomatous Osteomyelitis
Diffusely Abnormal Vertebral Bodies
Thanatophoric Dwarfism
Mucopolysaccharidoses
ESSENTIAL INFORMATION
Key Differential Diagnosis Issues
Single vertebrae with abnormal appearance usually post-traumatic
2 or more adjacent vertebrae with abnormal appearance usually segmentation anomaly
Helpful Clues for Common Diagnoses
Scheuermann disease causes undulating appearance of vertebral endplates
Cushing disease causes cupping deformity of vertebral endplates
Infection and neurogenic arthropathy are centered on intervertebral disc and show endplate erosions
Juvenile idiopathic arthritis results in vertebral bodies that are tall relative to anteroposterior diameter
Kümmell disease distinguished by gas in vertebral body
Sickle cell causes “Lincoln Log” deformity
Mucopolysaccharidoses and achondroplasia cause “bullet vertebrae” with anterior portion of body small
Vertebral bodies near apex of a scoliosis often mildly misshapen
Tumors involving only part of vertebral body may cause a dysmorphic appearance due to partial collapse
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