Rugger jersey spine

What is Rugger jersey spine?

Rugger jersey spine is the band-like osteosclerosis of the superior and inferior margins of the vertebral bodies.

This condition describes the prominent endplate densities at multiple contiguous vertebral levels to produce an alternating sclerotic-lucent-sclerotic appearance.

This disease mimics the horizontal stripes of a rugby jersey.

Rugger jersey spine is only seen in patients with secondary (not primary) hyperparathyroidism.


Osteoblasts form an increased amount of osteoid that does not contain hydroxyapatite.

This mechanism is in response to increased bone resorption due to excessive parathyroid hormone (PTH) secretion and subsequent loss of bone mass.

This feature does appear opaque on radiographs. 

The sclerotic bands on the superior and inferior endplates of the vertebral bodies represent accumulations of excess osteoid and appear opaque because of their increased volume when compared to normal bone.

Differential diagnosis

  • Paget disease
    • picture frame vertebral body
  • osteopetrosis
    • sandwich vertebrae
  • severe osteoporosis with compression fractures


  1. Terry R. Yochum, Lindsay J. Rowe. Yochum and Rowe’s Essentials of skeletal radiology. Philadelphia, Pa. : Lippincott Williams & Wilkins, c2005. ISBN:0781739462. Read it at Google Books – Find it at Amazon
  2. Wittenberg A. The rugger jersey spine sign. Radiology. 2004;230 (2): 4912. doi:10.1148/radiol.2302020388 – Pubmed citation


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