Musculoskeletal manifestations as the onset of acute leukemias in childhood

Acute lymphoblastic leukaemia presenting with atraumatic intermittent limp: a case report

“…Initial laboratory test results can be normal or show only discrete changes; bearing the differential of neoplasia in mind, Passarelli Lupoli Barbosa et al [8] even suggest requesting serial blood tests until there is a clearly defined diagnosis.…”

Childhood leukaemia masquerading as juvenile idiopathic arthritis

“…Initial presentation may involve the musculoskeletal system in up to two thirds of cases,3 and arthritis may be the only presenting feature of leukaemia 4. Consideration of other potential differential diagnoses when a child presents with unusual musculoskeletal symptoms may lead to earlier diagnosis of malignancy.…”

“…Barbosa et al showed that 62% of paediatric patients had musculoskeletal pain, but only 13% had clinical evidence of arthritis, at the onset of leukaemia; 8% of patients had been misdiagnosed with rheumatic fever or juvenile idiopathic arthritis before referral and some of these patients had already received steroids, delaying the start of appropriate treatment 3. However, differentiating rheumatic from malignant causes of musculoskeletal symptoms is difficult because early signs and symptoms are often similar.…”

Imaging of Malignant Bone Tumors

“…The choice of this age is because of their growing skeleton with massive red bone marrow. Common radiographic features in leukemia are generalized osteopaenia, metaphyseal lucent band, lytic bone lesions, metaphyseal cortical bone erosions, collapsed vertebra, widened sutures, and periosteal reactions [7,8].…”