Orthopedic manifestation as the presenting symptom of acute lymphoblastic leukemia.

Raj B K, Amrath; Singh, Kumar Amerendra; Shah, Hitesh · J Orthop · 2020

retrospective_cohort · Level III

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Abstract

The diagnosis of Acute lymphoblastic leukemia (ALL) is delayed due to vague presentation and normal hematological investigations. The objectives were to identify the frequency of ALL cases presented to the orthopedic department and with normal hematological investigations. 250 consecutive ALL cases were retrospectively evaluated to identify cases with musculoskeletal manifestations, and laboratory investigations. Twenty-two patients (4- vertebral compression fractures, 12- joint pain, 6- bone pain), presented primarily to the orthopedic department. Six patients had a normal peripheral smear. The primary physician should maintain a high index of suspicion despite a normal peripheral smear.