Painful Schmorl's node: Another cause of vertebral photopenia on indium- 111-labeled leukocyte scintigraphy

The authors describe an In-111-labeled leukocyte study in a 28-year-old man with lower back pain. SPECT images showed photopenia of the L2 vertebra. Plain radiographs showed disc space narrowing at the L2-3 level but no other abnormality. MRI showed a large, apparently intraosseous disc herniation (Schmorl's node) through the inferior endplate of L2 with associated extensive contrast-enhancing marrow edema and reactive changes. A repeated CT showed findings consistent with an intraosseous disc herniation. There was no evidence of infection or tumor. Thus a painful Schmorl's node may cause vertebral photopenia on labeled leukocyte scintigraphy, presumably because of associated marrow edema.