Sub periosteal hemorrhage is seen in: (Repeat)

Ans: A (Vitamin C deficiency) Ref: Nelson's Textbook of Pediatrics. 19th Edition, Page 198Explanation:Radiographic Changes in ScurvyThe typical radiographic changes occur at the distal ends of the long bones and are particularly common at the knees.The shafts of the long bones have a ground- glass appearance due to trabecular atrophy.The cortex is thin and dense, giving the appearance of pencil outlining of the diaphysis and epiphysis (Pencil thin cortex).The white line of Frankel. an irregular hut thickened white line at the metaphysis, represents the zone of well-calcified cartilage.The epiphyseal centers of ossification also have a ground-glass appearance and are surrounded by a sclerotic ring.The more specific but late radiologic feature of scurvy is a zone of rarefaction under the white line at the metaphysis. This zone of rarefaction (Trumerfeld zone), a linear break in the bone that is proximal and parallel to the white line, represents area of debris of broken-down bone trabeculae and connective tissue.A Pelkan spur is a lateral prolongation of the white line and may be present at cortical ends. Epiphyseal separation can occur along the line of destruction, with either linear displacement or compression of the epiphysis against the shaft.Subperiosteal hemorrhages are not visible using plain radiographs during the active phase of scurvy. However, during healing the elevated periosteum becomes calcified and radiopaque, giving a dumbbell or club shape to the affected bone.