Scheuermann's disease in patients 15-40 years old: A study to determine its prevalence and its relationship with age and sex using chest radiographs as screening tool.

BACKGROUND

There is insufficient knowledge of the epidemiology of Scheuermann's disease. The data available comes from estimations from young adults with obvious deformity, from studies evaluating children who may not have developed the deformity yet, or from older populations who can develop vertebral wedging secondary to other causes. We aimed to determine the prevalence of Scheuermann's disease in patients 15-40 years old using plain chest radiographs as a screening tool.

METHODS

We evaluated 454 patients aged 15-40 years old studied using standing plain chest radiographs. We measured thoracic kyphosis from T5 to T12; using the intraclass correlation coefficient (ICC), we determined inter- and intra-observer agreement. To determine the prevalence of Scheuermann's disease we used the Sorensen criteria. We performed a correlation analysis of thoracic kyphosis and age, and a linear regression to determine the impact of age and sex on the kyphosis angle.

RESULTS

The prevalence of Scheuermann's disease was 2.2% (0.9-3.5%). The prevalence was not different in females (1.4%) and males (2.8%), p = 0.36. Inter-and intra-observer agreements were excellent: ICC = 0.93 (0.84-0.97) and 0.97 (0.95-0.98). There was a small positive correlation of kyphosis angle with age (r = 0.110; p = 0.019). Linear regression revealed that age (ß = 0.138; p = 0.019) was an independent predictor of kyphosis angle, but sex was not (ß-coefficient = 0.007; p = 0.994).

CONCLUSION

We found a prevalence of Scheuermann's disease of 2.2%, without significant differences between males and females. Age independently influenced the kyphosis angle; sex did not. This study allows a better understanding of the epidemiology of Scheuermann's disease.