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Intervertebral Disk Calcification in Childhood

1963; Radiological Society of North America; Volume: 80; Issue: 3 Linguagem: Inglês

10.1148/80.3.399

1527-1315

John Melnick, Frederic N. Silverman,

Shoulder and Clavicle Injuries

Roentgenologic evidence of intervertebral disk calcification is infrequent in adult life; in childhood, it is an exceedingly uncommon finding. We have discovered in the available literature reports of 48 cases in the pediatric age group and have 5 additional cases of our own. From a careful review of the material, it would appear that certain aspects of the condition occur with sufficient frequency to merit consideration as a separate entity. According to Sandström (27), calcification of the intervertebral disks was first described by Luschka in 1858. Almost a half century later, it was demonstrated by Beneke (1897) in his Roentgen Study in the Cadaver. It was again described by Calvé and Galland in 1922 (6). The calcification was believed by Schmorl (30), according to his classical study of this subject in 1932, to be the result of a degenerative process, without clinical significance. In the same year Rathcke (23) reported microscopically visible calcification in intervertebral disks at all ages. In 1924, Baron (2) published the first case of intervertebral disk calcification in the pediatric age group. His patient was a twelve-year-old boy. The first case in the American literature is that of Weens (37), which was also the first to be reported in a female. Silverman (32), in 1954, added 7 new cases to the 8 then available in the literature. He demonstrated well developed calcification at six months of age and suggested that the group of children with cervical calcification, neck pain, and transient calcification differed from the group with persistent calcification and from those with disappearing calcification in other regions. Five further cases are reported here. Case Reports (Table I) Case I: J. H., white male, was born July 8, 1957, after a pregnancy of eight and a half months. The birth weight was 5 pounds and 2 ounces. Within twenty-four hours of birth, it was noticed that the infant was jaundiced, and on three occasions he vomited green material. He was transferred from the nursery for observation. Bilirubin was 12 mg. per cent at this time and fell to 9.8 mg. per cent by the third day. No blood incompatibility was found and, although blood cultures were negative, the infant was treated as if sepsis were present. He improved rapidly and was discharged on Aug. 6, 1957. The patient was hospitalized for a second time on Oct. 24, 1957, because of pneumonia, salicylism, and tonsillitis. Roentgen examination revealed, in addition to pneumonia, intervertebral disk calcification at the T-10, T-11, and T-12 levels. A review of a chest film taken on the initial hospitalization demonstrated that calcifications had been present at that time but had been overlooked. No interval change was noted. Roentgenograms of this case are reproduced in Figures 1 and 2. Case II: J. P., white female, was born Dec. 13, 1955, following a normal pregnancy. The birth weight was 5 pounds and 4 ounces.