Rheumatology Advance Access originally published online on May 22, 2008
Rheumatology 2008 47(7):1109; doi:10.1093/rheumatology/ken160
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Scurvy: MRI appearances
Ipswich Hospital NHS Trust, Ipswich, UK
Correspondence to: R. Watts. E-mail: richard.watts{at}ipswichhospital.nhs.uk
A 56-yr-old man was admitted with a 3-yr history of recurrent petechial rash, and monarthritis right knee. Examination revealed an extensive purpuric rash over the abdomen, legs and bruising over the knees and feet. Corkscrew hairs were present on the abdominal wall. A skin biopsy showed prominent interstitial haemorrhage involving the superficial and mid dermis without capillaritis, consistent with scurvy. MRI showed multiple small focal areas of marrow oedema throughout the metaphyseal regions of the distal femur and proximal tibia on T1-weighted and PD/SPIR images. A diagnosis of scurvy was made. His diet was completely devoid of fresh fruit and vegetables. Vitamin C replacement resulted in resolution of the rash. Repeat MRI (after 6 months) showed complete resolution of the bone marrow lesions.
The MRI appearances of scurvy are poorly documented. A previous description in a 5-yr-old child showed similar diffuse bone marrow signal changes (on T1- and T2-weighted images) in the femoral shaft. In addition there was subperiosteal fluid and displacement of the distal epiphysis [1]. The marrow appearances on MRI represent focal areas of haemorrhage or small infarcts. The MRI appearances completely resolve with vitamin C treatment.
Disclosure statement: The authors have declared no conflicts of interest.
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References
- Choi SW, Park S-W, Kwon YS, Oh IS, Kim WH, Suh CH. MR imaging in a child with scurvy: a case report. Korean J Radiol (2007) 8:443–7.[CrossRef][Web of Science][Medline]
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