Purpose or Case Report: Scurvy is a disease resulting from vitamin C (ascorbic acid) deficiency. While uncommon among children in economically developed countries, its recognition remains crucial for appropriate clinical management.

The clinical presentation of scurvy is variable, including cutaneous, dental, musculoskeletal, and systemic manifestations. Initial symptoms are frequently non-specific, such as irritability, anorexia, low-grade fever, and limb pain. The presence of coexisting neurodevelopmental disorders may further complicate history-taking and physical examination, leading to potential delays in diagnosis.

Magnetic Resonance Imaging (MRI) is frequently used in children with unclear symptoms. The differential diagnosis for this non-specific imaging appearance is broad and considerations include malignancy, infectious and inflammatory conditions.

Although previous case reports exist on imaging of scurvy, MRI findings have not been scrutinized in detail within the broad spectrum of abnormalities identifiable in different body parts. Scurvy should remain a key consideration in the differential diagnosis for children presenting with non-specific symptoms and multifocal MRI abnormalities. Early recognition with different imaging modalities, including MRI, can guide appropriate management and minimize unnecessary invasive procedures, including tissue sampling.

Our case series evaluates 4 pediatric patients with laboratory-confirmed scurvy and reviews the literature to outline the types and frequency of MRI findings associated with the condition. Our objective is to educate clinicians and radiologists about both common and rare MRI features of scurvy, aiming at reducing the rate of unnecessary invasive procedures (e.g. biopsy) for diagnosis of this entity, particularly when the clinical history is inconclusive.

Content organization:
1. Summary of clinical and imaging characteristics associated with scurvy.
2. Types and prevalence of MRI findings observed in pediatric scurvy.
3. Proposed decision-making algorithm for clinicians and radiologists to utilize when scurvy is suspected in pediatric patients.

Summary:
The main teaching points of this case review include:
1. Imaging findings of scurvy can be subtle; recognizing early signs is crucial.
2. Considering scurvy early can facilitate timely evaluation and reduce unnecessary procedures.
3. Timely diagnosis and treatment of scurvy improves outcomes and prevents complications.
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