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  • Open Access

Clues to remind leukemia in patients with arthritis: case presentations

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Pediatric Rheumatology20086 (Suppl 1) :P172

  • Published:


  • Public Health
  • Arthritis
  • Leukemia
  • Acute Lymphocytic Leukemia
  • Disease Onset
Acute lymphocytic leukemia (ALL) may initially present with musculoskeletal symptoms such as pain or swelling, even before appearance of blasts in the peripheral blood. Fifteen to 30% of all ALL patients have musculoskeletal complaints at disease onset. Such presentation may lead to misdiagnosis of the patients causing a delay in proper management. Here, we present 5 patients who were referred to Pediatric Rheumatology Department for the evaluation of arthritis and were finally diagnosed as ALL (table 1).
Table 1

Five patients who were referred to Pediatric Rheumatology Department for the evalution of arthritis and were finall diagnosed as ALL



Provisional diagnosis

Final diagnosis

10 y, ♂

Migratory arthritis, fatigue

Acute rheumatic fever


3 y, ♂

Fever, arthritis of the left hip

Septic arthritis


2 y, ♀

Arthritis of the right hip

Transient synovitis


3 y, ♂

Pain in legs, inability to walk



6 y, ♀

Arthritis of the left elbow, fatigue

Postviral arthritis


The peripheral blood changes were absent or subtle in these patients. Some clinical, laboratory, and radiological clues helped to establish the diagnosis of ALL. We aimed to discuss the usefulness of history, physical findings, and simple laboratory and radiographic tests in decision-making.

Authors’ Affiliations

Dokuz Eylul University Hospital, Izmir, Turkey


© Makay et al; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.