Scheuermann Kyphosis Differential Diagnoses

Updated: Feb 15, 2019
  • Author: Clifford Tribus, MD; Chief Editor: Jeffrey A Goldstein, MD  more...
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DDx

Diagnostic Considerations

Differentiating normal thoracic kyphosis from abnormal thoracic kyphosis (Scheuermann kyphosis, or Scheuermann disease) is somewhat problematic. Normal thoracic kyphosis is actually dynamic throughout life and typically increases.

Fon et al measured thoracic kyphosis in 316 normal subjects (159 male, 157 female). [22]  In those younger than 10 years, the average kyphosis was 20.88° with a standard deviation (SD) of 7.85 for boys and 23.87° with an SD of 6.67 for girls. In adolescents, the kyphosis had increased to an average of 25.11° with an SD of 8.16 in boys and 26.00° with an SD of 7.43 in girls.

Females, on average, have slightly greater kyphosis in the thoracic spine throughout life, and this difference between males and females increases further when they are older than 40 years. Fon et al found that in women aged 50-59 years, the average kyphosis measured 40.71° with an SD of 9.88°, whereas men in the same age group had an average thoracic kyphosis of 33.00° with an SD of 6.46. [22]

Shelton et al reported on the diagnosis and management of kyphosis in adolescents. [23, 24]  

For purposes of definition, any degree of kyphosis of more than 40° should be deemed abnormal. Additionally, any degree of kyphosis at the thoracolumbar junction or in the lumbar area of the spine should be considered abnormal.