Scheuermann Disease Evaluation of Radiological Criteria and Population Prevalence

Study Design. Observational population-based study. Objective. To determine the prevalence of radiographical Scheuermann disease in a Dutch population and evaluate the consistency of diagnostic criteria. Summary of Background Data. Scheuermann disease is a form of osteochondrosis characterized by increased posterior rounding of the thoracic spine with structural vertebral deformity. Different expert opinion-based radiological criteria exist, yet these have not been validated. The prevalence in the general population reported ranged from 1% to 10%. Methods. Lateral spine radiographs of 2753 Rotterdam Study participants (aged 45-89 yr) were assessed for Scheuermann disease using Sorensen and Sachs' radiographical criteria in 2 phases. Cohen. statistics were calculated for interrater agreement. Prevalence estimates were calculated and sex differences were tested with Pearson. 2 test. We evaluated whether varying the kyphosis angle criterion would change the prevalence estimate. Results. A total of 677 (24.6%) individuals had endplate irregularities and 140 (5.1%) individuals had vertebral wedging. Abnormalities were significantly more prevalent among males (P < 0.05). The interrater agreement. statistics were 78.8% for vertebral wedging and 79.4% for endplate irregularity. A total of 127 individuals had both criteria, of which 111 had a kyphosis angle greater than 45, resulting in a prevalence of 4.0% (95% confi dence interval [CI]: 3.3%-4.7%). The disease prevalence w Conclusion. Our results revealed a prevalence of 4.0% of radiographical Scheuermann disease in Dutch individuals aged 45 years and older. Although there is no current " gold standard" for the radiographical definition, standardized scoring of independent features resulted in substantial interobserver agreement, and different applications of diagnostic criteria did not signifi cantly alter the classification.