19 July 2023
: Case report
Unusual Presentation of Pediatric Scurvy: A Necrotic Gastrostomy Tube Site in a 14-Year-Old Boy
Unusual clinical course, Challenging differential diagnosis, Rare disease
Nicholas R. Zessis
DOI: 10.12659/AJCR.940770
Am J Case Rep 2023; 24:e940770
Figure 3. Sagittal short tau inversion recovery image of the right knee demonstrating regional areas of T2 hyperintense signal centered in the distal femoral metaphysis and proximal tibial metaphysis, compatible with the MRI findings of scurvy (arrows) [4,24]. The lack of knee joint effusion, intra-osseous or subperiosteal abscess, argues against osteomyelitis and septic joint. Additionally, osteomyelitis is unlikely to affect the femoral and tibial metaphyses with relative sparing of the epiphyses and without intervening joint effusion [2,4,24]. MRI demonstrates a predictable pattern in scurvy, with symmetric areas of T2 hyperintensity and enhancement predominately in the long-bone metaphyses [2,4,5,24]. Subperiosteal fluid and soft-tissue edema may also be seen [4,24].