Authors
Dave Swaby, Enjuli Chhaniara, Mai Vue, Sonia Dubey
Published in
Cureus. Volume 18. Issue 8. Pages e114135. Epub Aug 07, 2026.
Abstract
Although rare in high-income countries, scurvy remains an important consideration in children with longstanding and highly restrictive eating habits, particularly those with autism spectrum disorder (ASD). Children with scurvy often undergo evaluation for infection, inflammatory bone disease, or malignancy before the diagnosis becomes apparent. This report describes an eight-year-old non-verbal boy with ASD who presented with progressive lower extremity pain and refusal to bear weight or walk. Imaging demonstrated diffuse osteopenia with classic metaphyseal changes of scurvy on radiographs, multiple vertebral compression deformities, and multifocal marrow signal abnormalities on MRI that closely mimicked chronic recurrent multifocal osteomyelitis (CRMO). Further assessment revealed a markedly restricted diet, characteristic skin findings, and a serum vitamin C level < 0.1 mg/dL, confirming the diagnosis of scurvy. Additional nutritional deficiencies of vitamins A, D, and E were identified. Following initiation of nutritional rehabilitation including vitamin C therapy, the patient experienced rapid improvement, with resolution of pain and restoration of weight-bearing ability. This case illustrates that pediatric scurvy can closely mimic CRMO clinically and radiographically, highlighting an important diagnostic pitfall and emphasizing the importance of careful dietary assessment to avoid unnecessary invasive diagnostic procedures.
PMID:
42703464
Bibliographic data and abstract were imported from PubMed on 07 Sep 2026.
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