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Scurvy

Case contributed by Pir Abdul Ahad Aziz Qureshi
Diagnosis almost certain

Presentation

Bleeding gums, swelling of bilateral thighs, and pain.

Patient Data

Age: 1 year
Gender: Female
x-ray

Bilateral pencil-thin cortex is noted. Lucent metaphyseal band underlying the dense provisional zone of calcification is noted bilaterally representing the Trümmerfeld zone and Frankel line respectively. Metaphyseal spurs are also noted bilaterally involving the bilateral femora and tibia representing Pelkin spur. Circular calcification is also seen surrounding the epiphyses of bilateral femora and tibia representing the Wimberger ring sign. Soft tissue swelling with large paradiaphyseal calcification is seen along the right femur.

Case Discussion

Scurvy is caused by a dietary deficiency of ascorbic acid (vitamin C), therefore, it is also called hypovitaminosis C. It is characterized by an increased bleeding tendency and impaired collagen synthesis resulting in osteoporosis and impaired wound healing. 

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