Figure 2. Anterior-posterior right knee radiograph demonstrating diffuse osteopenia. There is increased density at the zone of provisional calcification compatible with a Frankel’s line as seen in scurvy (thin arrow) [4]. The distal femoral growth plate is distorted and irregular, producing doubled appearance related to different heights of the posterior and anterior physis (short arrows). The patient is status post hardware removal. Plain films commonly show osteopenia, though this is nonspecific [4,9], as well as thin cortex, signs of subperiosteal fluid (if it ossifies, representing edema or hemorrhage), and microfractures [1,4,9]. The most specific findings include the white line of Frankel (a thickened and irregular calcification at the metaphysis), and the Trummerfeld zone (zone of lucency on the diaphyseal side of the line of Frankel), which is a late finding [2–5,9]. Pelkan spurs (healing metaphyseal fractures) and Wimberger rings (thin and sclerotic cortex surrounding a lucent epiphysis) are also classic to scurvy [3–5]. While specific, these findings are not sensitive and are often either absent or overlooked.