The differential diagnosis for this appearance includes hematologic malignancies such as leukemia and nutritional disorders. Chronic recurrent multifocal osteomyelitis (CRMO) is considered less likely given the symmetry. Withheld history, in this case, is that this 3-year-old boy had a history of autism, sensory processing disorder and poor dietary intake consisting mainly of crackers, yoghurt and water. Blood tests showed no evidence of leukemia however his ascorbic acid (Vitamin C) level was undetectable. A presumptive diagnosis of scurvy was made and the patient was treated with 1g ascorbic acid for 2 days followed by 100mg ascorbic acid three times a day. Iron, vitamin D and other nutritional supplementation was also commenced. The patient made a rapid symptomatic improvement and no further imaging was obtained.