Scurvy, Clinical features, Etiology, radiography, Treatment.

It is a nutritional disorder by deficiency of vitamin C and is characterized clinically by a generalized hemorrhagic tendency. The severe form of disease is rare and mild varieties are more common. Deficiency targets the cells of skeletal system more often. 

Etiology:-
  • Most frequent between 5 & 10 months in artificially fed infants. 
  • Vitamin C deficient diet. 
  • When seen with rickets it is called Barton's disease. 
History:-
  • More than half the crew of Vasco da Gama died from scurvy on his first trip(1497-99) around the Cape of Good Hope. 
  • In 1747, the Scottish naval surgeon James Lind treated scurvy- ridden sailors with lemons and orange and obtained dramatic cures. 
  • In 1795, the British navy began to distribute regular rations of lime juice during long sea voyages and this was successful in prevention scurvy. It was probably the first disease to be definitely associated with a dietary deficiency. 
Clinical features:-

The affected child is restless, pale and febrile. The affected limb is swollen, tender, and painful, muscles are in spasm and the child loathes using the limb. This voluntary immobilization of the extremities is called pseudoparalysis. Thevgums display a bluish, spongy swelling especially around the upper central incisor teeth. Brittle and loose teeth, ecchymosis beneath the skin, haematemesis, haematuria, anemia, weight loss, anorexia, etc. Are the other features. Sometimes even death supervenes. Mild form of scurvy are more common. In adult pain and tenderness over the bone and fracture with mild trauma is suggestive. 

Radiography:-

The lower femur, the upper tibia and the upper humerus are favored sites for epiphyseal fracture separation. Costochondral separation is typical. 

Treatment:-

Treatment is essentially conservative and consists of supplementing Vitamin C in the diet and also encouraging the child to take foods in other vitamins. The painful joints and the fracture need to be immobilized with plaster splits. 

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