Scurvy

  • Etiology: Vitamin C deficiency leading to impaired collagen synthesis
  • Imaging Radiograph:
    — Osteopenia
    — Pencil point cortical thinning
    — Trummerfeld zone (field of rubble) metaphyseal lucencies
    — Pelkan spur causing metaphyseal cupping
    — Frankel line is irregular white line at metaphysis due to dense zone of provisional calcification
    — Wimberger ring sign is epiphyseal shell with central lucency
    — Subperiosteal hemorrhage that calcifies with healing
  • DDX:
  • Complications: Bleeding tendency, impaired wound healing
  • Treatment:
  • Clinical:

Radiology Cases of Scurvy

Radiograph of scurvy
AP and lateral radiographs of the lower extremity show thinned cortices and calcified subperiostial hemorrhage around the distal femurs, left greater than right.
Radiograph of scurvy
CXR AP (above) shows a destructive process in the left humeral metaphysis while AP radiograph of the hip (below left) shows a large amount of subperiosteal hemorrhage around the proximal femur. AP radiograph of the hip taken several months later after initiation of nutritional therapy (below right) shows substantial interval bony remodeling of the proximal femur.