• Ater A Makurthou, Ling Oei, Salih El Saddy, Stephan J Breda, Martha C Castaño-Betancourt, Albert Hofman, Joyce B J van Meurs, André G Uitterlinden, Fernando Rivadeneira, and Edwin H G Oei.
• 1Department of Internal Medicine, Erasmus Medical Center Rotterdam, The Netherlands 2Department of Radiology, Erasmus Medical Center Rotterdam, The Netherlands 3Department of Epidemiology, Erasmus Medical Center Rotterdam, The Netherlands 4Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands.
• Spine. 2013 Jun 11.

AbstractStudy Design: Observational population-based studyObjective: Determine the prevalence of radiographic Scheuermann's disease in a Dutch population and evaluate the consistency of diagnostic criteria.Summary of Background Data: Scheuermann's 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 ranges from 1% to 10%.Methods: Lateral spine radiographs of 2,753 Rotterdam Study participants (aged 45-89) were assessed for Scheuermann's disease using Sørensen and Sachs' radiographic criteria in two phases. Cohen's kappa statistics were calculated for inter-rater agreement. Prevalence estimates were calculated and gender differences were tested with Pearson's chi-square test. We evaluated if varying the kyphosis angle criterion would change the prevalence estimate.Results: 677 individuals (24.6%) had endplate irregularities and 140 (5.1%) had vertebral wedging. Abnormalities were significantly more prevalent among men (p<0.05). The inter-rater agreement kappa statistics were 78.8% for vertebral wedging and 79.4% for endplate irregularity. 127 had both criteria, of which 111 had a kyphosis angle greater than 45 degrees, resulting in a prevalence of 4.0% (95% CI:3.3%-4.7%). The disease prevalence was 4.5% in men vs. 3.6% in women, yet this difference was not statistically significant (p = 0.23). Adjustment of the kyphosis angle criterion from 45 to 40 or 35 degrees increased the number of cases marginally, corresponding to prevalence estimates not significantly different from the estimates using original criteria (4.2% [3.3-4.7%] and 4.4% [3.6%-5.2%]).Conclusion: Our results revealed a prevalence of 4.0% of radiographic Scheuermann's disease in Dutch individuals aged 45 years and over. Although there is no current gold standard for the radiographic definition, standardized scoring of independent features resulted in substantial inter-observer agreement, and different applications of diagnostic criteria did not significantly alter the classification.

15 keywords...

hide…