rugbScheuermann’s Disease Posted on Thursday, September 11, 2003 - 00:00 Synonyms: Vertebral epiphysitis, Adolescent Kyphosis Mechanism of Injury: This is an overload injury affecting the vertebral ring growth plate. It is most likely caused by multiple minor traumata. Short hamstring muscles may create an increased load on the thoraco-lumbar junction when bending, thereby damaging the growth plate. Incidence:  - More Common in Males - 13 - 17 years of age Sports Any sport which loads the spine, e.g. rugby, weightlifting, wrestling. Symptoms:  - Pain this is aggravated by exercise - usually afterwards which is aggravated by long sitting, e.g. in class. - Deformity in severe cases a kyphotic deformity occurs usually found in the lower thoracic region Signs: - Deformity (kyphosis) is often picked up by the school doctor or nurse. Tenderness, usually found in the lower back region. - Muscle spasm - this is variable depending on the severity of the condition Differential - Cause of Kyphosis Diagnosis:- - Compression fracture Tuberculosis Investigations: - X-rays Three stages are seen: Florid anterior wedging of the vertebral body vertebral body surfaces are irregular mottling of the ring growth plates narrowed intervertebral space Destructive growth plates fragmented disappearance of upper and lower anterior angles of the body Reparative Density returns to the epiphyses The vertebral body is wedged Nuclear prolapse of the disc into the vertebral body Treatment: - Prevention of Deformity Extension exercises Bracing only when there is severe pain · Reduction of inflammation Non-steroidal anti-inflammatory drugs Analgesics Rest. Most adolescents can continue with sport. In rugby the tight five forwards may continue as soon as the acute pain is gone. Results: Unfortunately many cases are left with a permanent kyphosis Article by: Dr Clive Noble (SA RUGBY MEDICAL COMMITTEE)