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Of oranges and lemons: you are what you eat
  1. La Reina Sangaran1,
  2. John-Paul Smith2,
  3. Flavia Menegotto3,
  4. Athimalaipet V Ramanan1,4
  1. 1 Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
  2. 2 Paediatrics, Royal Devon and Exeter Hospital, Exeter, UK
  3. 3 Paediatric Radiology, Bristol Royal Hospital for Children, Bristol, UK
  4. 4 Translational Health Sciences, University of Bristol, Bristol, UK
  1. Correspondence to Dr La Reina Sangaran, Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol BS2 8BJ, UK; lareinasangaran{at}


A young boy presented with increasing lower limb pain and swelling for a month. At the time of his hospitalisation, he was unable to walk. We report the patient’s clinical journey with clinical commentary throughout, highlighting the importance that uncommon diseases may be diagnosed with a high index of suspicion and thorough history taking.

  • Paediatrics
  • Rheumatology
  • Child Health
  • Micronutrients

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  • Contributors LRS wrote the manuscript and performed the literature search. J-PS, FM and AVR did the clinical case management and edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.