Scurvy: a rare case in an adult.

Abstract:

:A 69-year-old man presented with unilateral calf pain, swelling, and erythematous rash. He was initially treated with antibiotics for suspected cellulitis. A venous duplex ultrasound, performed to exclude deep venous thrombosis, revealed multiple heterogeneous hypoechoic foci of unknown etiology throughout the calf musculature. His condition did not improve with antibiotics, instead progressing to a necrotic ulcer along the medial malleolus. Clinical suspicion of vascular insufficiency or vasculitis prompted an extensive imaging work-up. CT and MRI revealed the intramuscular abnormalities observed on previous ultrasound represented foci of intramuscular hemorrhage. Marrow signal abnormality was also noted in the proximal tibia. A punch biopsy of the skin rash ultimately demonstrated distorted hair follicles with perifollicular inflammation and hemorrhage concerning for scurvy. The diagnosis was confirmed by low vitamin C levels and dietary history. A resurgence of scurvy has occurred in the pediatric population in recent years. However, this diagnosis remains uncommon in adults, with limited reports of the potential advanced imaging findings in the current literature.

journal_name

Skeletal Radiol

journal_title

Skeletal radiology

authors

Joshi R,Gustas-French CN,Fanburg-Smith JC,Helm KF,Flemming D

doi

10.1007/s00256-018-3069-3

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

977-984

issue

6

eissn

0364-2348

issn

1432-2161

pii

10.1007/s00256-018-3069-3

journal_volume

48

pub_type

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