Written By: IJCP Editorial Team

Published On: 17 Apr, 2025 1:07 PM | Updated On: 25 Apr, 2025 1:19 PM

A Case Report of diagnosing Scurvy in a 4-Year-Old Boy with Progressive Limb Pain

Vitamin C deficiency can significantly contribute to walking pain, but its various symptoms may not appear simultaneously, complicating diagnosis. This report discusses a 4-year-old boy who underwent numerous tests before being diagnosed with scurvy.

The child presented with worsening pain and difficulty bearing weight over three months, experiencing bilateral lower limb pain without fever, joint swelling, or rash, initially misdiagnosed as growing pains. A bruise was later discovered on his ankle, leading to a soft tissue injury diagnosis, for which he was treated with steroids, non-steroidal anti-inflammatory drugs, and vitamin D. However, as there was no improvement, further investigations were conducted, revealing mild anemia (Hb: 10.3 g%) with normal platelets and CRP levels. Tests for autoimmune conditions were negative, and imaging studies, including ultrasound and MRI, showed no muscle tears or effusions. 

The child was then referred, where a positive Gower sign was noted, and his dietary history indicated a lack of fruit and citrus intake. Suspecting scurvy, an X-ray of the knees showed osteopenia and Trummerfeld’s zones, but no fractures or injuries. The child was prescribed vitamin C supplements, and within six weeks, he gradually improved, regained the ability to bear weight, and all symptoms resolved.

This case underscores the importance of taking a thorough dietary history and performing basic tests, such as an X-ray, to confirm a scurvy diagnosis. It also emphasizes that scurvy should be considered when evaluating a child with progressive limb pain, even in the absence of risk factors.

Source: Agarwal S, Shah A. Scurvy in a Preschooler - A Forgotten Nutritional Deficiency. Indian J Pediatr. 2025. https://doi.org/10.1007/s12098-025-05463-4