Musculoskeletal manifestations in pediatric acute leukemia

Area of Science:

• Pediatric Oncology
• Orthopedics
• Hematology

Background:

• Acute leukemia (AL) in children can present with musculoskeletal symptoms, often delaying diagnosis.
• These symptoms can mimic various orthopedic pathologies, necessitating increased awareness.

Purpose of the Study:

• To delineate the clinical and radiological musculoskeletal manifestations of childhood acute leukemia.
• To assess the correlation between these manifestations and patient outcomes.

Main Methods:

• Retrospective review of 122 children diagnosed with AL between 1984 and 1999.
• Analysis of clinical presentations, radiographic abnormalities, and survival rates.
• Statistical analysis using the chi2 test.

Main Results:

• Musculoskeletal complaints were frequent (38.3%), including pain, functional impairment, and limping.
• Radiographic abnormalities were present in 40.2% of patients at diagnosis, with osteolysis being common.
• Late radiographic lesions were uncommon, possibly due to milder treatment protocols.

Conclusions:

• Clinical and radiological findings in childhood AL are variable and lack uniform localization.
• No significant correlation was found between symptoms and radiological lesions, nor were radiographic abnormalities or leukemia type prognostic factors.
• Early diagnosis of AL is vital for reducing morbidity and mortality; orthopedists should consider AL in children with unexplained skeletal symptoms.