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[Malignant disease presenting as rheumatic manifestations].
I Dorronsoro Martín1, R Merino Muñoz, A Sastre-Urguellés
1Unidad de Reumatología Pediátrica, Hospital Universitario La Paz, Madrid, Spain. reumaped.hulp@salud.madrid.org
Anales De Pediatria (Barcelona, Spain : 2003)
|November 9, 2004
Summary
Pediatric musculoskeletal pain can signal underlying cancer. Early recognition of symptoms like joint pain, limping, or back pain, alongside abnormal lab results, is crucial for timely diagnosis of childhood malignancies.
Area of Science:
- Pediatric Rheumatology
- Pediatric Oncology
- Medical Diagnostics
Context:
- Musculoskeletal pain is a common pediatric complaint.
- It can be the initial sign of serious underlying conditions like cancer.
Purpose:
- To detail the clinical features and diagnostic findings in children with cancer referred to pediatric rheumatology.
- To highlight the importance of considering malignancy in pediatric differential diagnoses.
Summary:
- A retrospective review identified 10 pediatric cancer cases (0.25%) among 3,982 referrals.
- Common presentations included arthralgias, limp, and back pain, with leukemia and Langerhans' cell histiocytosis being frequent.
- Diagnostic tools included laboratory tests (anemia, elevated ESR, LDH) and imaging, confirmed by bone marrow aspirate or biopsy.
Impact:
- Underscores the need to include malignancies in the differential diagnosis for pediatric musculoskeletal pain.
- Emphasizes the role of clinical presentation, laboratory, and imaging studies in identifying occult cancers.
- Highlights the low but significant incidence of malignancy presenting as rheumatologic symptoms in children.