Musculoskeletal manifestations with subtle haematological and radiological abnormalities in childhood acute lymphoblastic leukaemia

N. S. Shaliza, A. Hamzah Faizal, Hashim Embong

Research output: Contribution to journalArticle

Abstract

Musculoskeletal manifestations may be the only apparent abnormality at the onset of disease in childhood acute lymphoblastic leukaemia (ALL). These clinical presentations are often misdiagnosed as diverse forms of orthopaedic and rheumatologic disease, therefore contributes to delay in diagnosis and treatment. We report the case of a 3-year-old child who was diagnosed with ALL after recurrent visits with persistent painful left ankle swelling. Initial haematological and radiological findings revealed subtle abnormalities. A bone marrow aspiration confirmed the diagnosis of precursor-B ALL. This case highlights that acute leukemia needs to be considered in the differential diagnosis in any child presenting with musculoskeletal pain and unexplained lymphocytosis and neutropenia. Radiological abnormalities include diffuse osteopaenia, radiolucent metaphyseal bands, osteolytic lesion and sclerotic lesions which may raise the suspicion of acute leukemia, but are not always pathognomonic. Delay in diagnosis and treatment may have a deleterious impact on prognosis.

Original languageEnglish
Pages (from-to)293-296
Number of pages4
JournalBrunei International Medical Journal
Volume10
Issue number5
Publication statusPublished - 2014

Fingerprint

Precursor Cell Lymphoblastic Leukemia-Lymphoma
Leukemia
Musculoskeletal Pain
Lymphocytosis
Neutropenia
Diagnostic Errors
Ankle
Orthopedics
Differential Diagnosis
Bone Marrow
Therapeutics

Keywords

  • Atypical manifestations
  • Cellulitis
  • Childhood leukemia
  • Lymphocytosis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Musculoskeletal manifestations with subtle haematological and radiological abnormalities in childhood acute lymphoblastic leukaemia. / Shaliza, N. S.; Faizal, A. Hamzah; Embong, Hashim.

In: Brunei International Medical Journal, Vol. 10, No. 5, 2014, p. 293-296.

Research output: Contribution to journalArticle

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