Acute leukemia presenting as arthritis in children

The clinical and laboratory features of six children with arthritis as the presenting manifestation of acute leukemia are reviewed. Asymmetric arthritis involving the large joints of the extremities was the dominant clinical feature in all patients. Despite the presence of antinuclear antibody in three patients, other laboratory features, particularly hematologic abnormalities, served as clues to the diagnosis of leukemic arthropathy in most patients.