Symptoms
Usually the first symptoms to appear are tenderness of the legs. This will be observed from the fact that the child cries when his legs are moved. Eventually this tenderness localizes about the knees and ankles and it is accompanied with swelling of these parts. The gums then become swollen and show a marked tendency to bleed. This swelling may produce pain sufficient to interfere with the child taking food. The child loses weight, becomes very fretful, and has a slight fever. There is a characteristic posture in which the hips are rotated outward, while there is a semi-flexion of the thighs and legs. The child will usually lie very quietly because any movement produces pain, especially in the legs. There is marked sub-periosteal hemorrhages which may be so great that the limbs will become twice their normal size. In severe cases epiphyseal separation is not uncommon. Scurvy is very often associated with rickets. However, it is affirmed that they are two separate conditions and not just different forms of the same condition.