Arthritic presentation of childhood malignancy: beware of normal blood counts

Some children with malignancy (e.g. acute lymphoblastic leukemia) who initially present with musculoskeletal complaints may be misdiagnosed as having a rheumatological disorder. In the literature, importance has been given to subtle changes in blood counts, which may point toward an underlying malig...

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Bibliographic Details
Published in:Rheumatology international 2011-06, Vol.31 (6), p.827-829
Main Authors: Suri, Deepti, Ahluwalia, Jasmina, Sachdeva, Man Updesh Singh, Das, Reena, Varma, Neelam, Singh, Surjit
Format: Article
Language:English
Subjects:
Arthritis, Juvenile - blood
Arthritis, Juvenile - diagnosis
Arthritis, Juvenile - etiology
Blood Cell Count - statistics & numerical data
Bone Marrow Examination
Bone Marrow Neoplasms - blood
Bone Marrow Neoplasms - complications
Bone Marrow Neoplasms - secondary
Child, Preschool
Diagnosis, Differential
Diagnostic Errors - prevention & control
Female
Humans
Male
Medicine
Medicine & Public Health
Neuroblastoma - blood
Neuroblastoma - complications
Neuroblastoma - diagnosis
Precursor Cell Lymphoblastic Leukemia-Lymphoma - blood
Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications
Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis
Reference Values
Rheumatology
Short Communication
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Summary:Some children with malignancy (e.g. acute lymphoblastic leukemia) who initially present with musculoskeletal complaints may be misdiagnosed as having a rheumatological disorder. In the literature, importance has been given to subtle changes in blood counts, which may point toward an underlying malignancy. We report 3 children with malignancy, who had an arthritic presentation but had normal blood counts at presentation. Atypical clinical pattern, significant nocturnal pain, pain out of proportion to joint involvement and prominent systemic features in these children prompted us to do a bone marrow examination that revealed a malignancy. Pediatricians must be aware of the arthritic presentation of childhood malignancy. If the clinical features point toward a malignancy, bone marrow examination should always be performed even if the blood counts are normal.
ISSN:0172-8172
1437-160X
DOI:10.1007/s00296-010-1584-1