Related Experiment Video
Updated: Jul 5, 2025
Cell-based Assay Protocol for the Prognostic Prediction of Idiopathic Scoliosis Using Cellular Dielectric Spectroscopy
Published on: October 16, 2013
What Do We C in Children With Scurvy? A Case Series Focused on Musculoskeletal Symptoms
Stephanie P Gilley1, Allison Ta1,2,3, William Pryor4,5
1Department of Pediatrics, Sections of Nutrition.
Insights
Vitamin C deficiency (scurvy) in children often presents with musculoskeletal pain. Early recognition of these symptoms, especially in those with neurodevelopmental disorders, can improve care and reduce costs.
Area of Science:
- Pediatrics
- Nutritional Science
- Musculoskeletal Medicine
Background:
- Vitamin C deficiency, or scurvy, frequently manifests with musculoskeletal symptoms in children, including gait disturbance and pain.
- Early diagnosis of scurvy is crucial to prevent severe complications and manage care effectively.
Purpose of the Study:
- To identify features aiding early diagnosis of scurvy in children.
- To estimate the healthcare costs associated with scurvy presenting with musculoskeletal symptoms.
Main Methods:
- Retrospective chart review of patients diagnosed with vitamin C deficiency or scurvy.
- Analysis of presenting symptoms, medical history, and diagnostic workups.
- Utilization of the Pediatric Health Information System for cost analysis.
Main Results:
- 47 patients diagnosed with scurvy were identified; 49% had neurodevelopmental disorders.
- Musculoskeletal symptoms were present in 16 patients, with costs averaging $14,137 per patient.
- Diagnostic workups were extensive, including imaging and invasive procedures, contributing to high costs.
Conclusions:
- Vitamin C deficiency can affect children across the BMI spectrum, particularly those with neurodevelopmental disorders.
- Increased awareness of scurvy's musculoskeletal signs can lead to earlier diagnosis and reduce unnecessary testing and healthcare expenses.
Objectives:
Vitamin C deficiency in children commonly presents with musculoskeletal symptoms such as gait disturbance, refusal to bear weight, and bone or joint pain. We aimed to identify features that could facilitate early diagnosis of scurvy and estimate the cost of care for patients with musculoskeletal symptoms related to scurvy.
Methods:
We conducted a retrospective chart review of patients at a single site with diagnostic codes for vitamin C deficiency, ascorbic acid deficiency, or scurvy. Medical records were reviewed to identify characteristics including presenting symptoms, medical history, and diagnostic workup. The Pediatric Health Information System was used to estimate diagnostic and hospitalization costs for each patient.
Results:
We identified 47 patients with a diagnosis of scurvy, 49% of whom had a neurodevelopmental disorder. Sixteen of the 47 had musculoskeletal symptoms and were the focus of the cost analysis. Three of the 16 had moderate or severe malnutrition, and 3 had overweight or obesity. Six patients presented to an emergency department for care, 11 were managed inpatient, and 3 required critical care. Diagnostic workups included MRI, computed tomography, echocardiogram, endoscopy, lumbar puncture, and/or EEG. Across all patients evaluated, the cost of emergency department utilization, imaging studies, diagnostic procedures, and hospitalization totaled $470 144 (median $14 137 per patient).
Conclusions:
Children across the BMI spectrum, particularly those with neurodevelopmental disorders, can develop vitamin C deficiency. Increased awareness of scurvy and its signs and symptoms, particularly musculoskeletal manifestations, may reduce severe disease, limit adverse effects related to unnecessary tests/treatments, and facilitate high-value care.
Related Concept Videos
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:28Disorders of the Skeletal Muscle
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
01:22The Functions of the Skeletal System
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
01:02What is the Skeletal System?
01:20Introduction to the Skeletal System
Components of the Skeletal System
Bone, or osseous tissue, is a hard connective tissue that forms an internal support structure for the human body. Bones shield vulnerable organs and soft tissue from external forces. For example, the vertebral bones protect and support the spinal cord.
Cartilage, a semi-rigid connective tissue found in regions such as...