PURPOSE Scurvy, due to vitamin C deficiency, is commonly referenced as a "forgotten" or "historical" disease. A growing number of case reports challenge this notion. Bone health providers are often consulted early in the presentation of scurvy to evaluate musculoskeletal complaints resulting from impaired collagen production and disrupted endochondral bone formation. In this report, we describe two cases of childhood scurvy. Our objective is to summarize the key features of scurvy for bone health providers, with the goal of raising awareness and facilitating diagnosis in future cases. CASE DESCRIPTIONS Case one occurred in a 12-year-old non-verbal, non-ambulatory female on a ketogenic diet for refractory epilepsy. Clinical findings included hemarthrosis, transfusion dependent anemia, elevated inflammatory markers, and epiphysiolysis. Magnetic resonance imaging (MRI) revealed multi-focal bone marrow signal abnormalities and physeal irregularities. Case two occurred in a typically developing 5-year-old male presenting with limp and knee pain. Symptoms progressed despite casting and immobilization. Mild anemia, elevated inflammatory markers, and multi-focal marrow and physeal MRI abnormalities were identified. Subsequent dietary history revealed total absence of fruit or vegetable consumption. The diagnosis of scurvy was confirmed in both cases by undetectable plasma vitamin C concentrations. Treatment with vitamin C led to rapid clinical improvement. CONCLUSION Scurvy can no longer be considered a historical diagnosis and should not be forgotten when evaluating children with musculoskeletal ailments. Early recognition of the signs, symptoms, and imaging findings of scurvy can reduce the clinical burden of this disease with the timely initiation of vitamin C therapy.

中文翻译：

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不再是一种历史性疾病：两例儿童坏血病，并向骨健康保健人员提供了建议。

用途由于维生素C缺乏症，坏血病通常被称为“被遗忘”或“历史性”疾病。越来越多的案例报告对这一概念提出了挑战。经常在坏血病表现的早期就咨询骨健康提供者，以评估由于胶原蛋白生产受损和软骨内骨形成破坏而引起的肌肉骨骼疾病。在本报告中，我们描述了两例儿童坏血病。我们的目标是为骨骼健康提供者总结坏血病的主要特征，以期提高认识并促进将来病例的诊断。病例描述病例1发生在一名12岁的非语言，非卧床女性中，该女性因难治性癫痫而采用生酮饮食。临床发现包括血栓形成，依赖输血的贫血，炎症标志物升高，和骨physi溶解。磁共振成像（MRI）显示多灶性骨髓信号异常和骨赘不规则。案例2发生在一名典型的发展中的5岁男性，表现为li行和膝盖疼痛。尽管进行了铸造和固定，但症状仍在发展。确定了轻度贫血，炎症标志物升高以及多灶性骨髓和干性MRI异常。随后的饮食史表明完全没有食用水果或蔬菜。在两种情况下，血浆维生素C浓度均未检出，可诊断为坏血病。维生素C的治疗导致临床快速改善。结论在评估患有肌肉骨骼疾病的儿童时，坏血病不再被视为历史诊断，也不应被遗忘。及早发现症状，体征，