Skeletal Manifestations of Acute Lymphoblastic Leukemia in Two Pediatric Cases

Pediatric leukemia is one of the most common pediatric malignancies, representing one quarter of all pediatric cancers. In the USA, the annual incidence is between 3.7 and 4.9 per 100,000 children aged 1-14 years, with peak incidence aged 2-5 years [1]. Both acute and chronic leukemia can present with a variety of symptoms and signs involving multiple systems in the body. Skeletal involvement in leukaemia was reported during early twentieth century [2]. These symptoms can involve bones, joints, and soft tissues. For example, bone pain, limping, arthritis, osteomyelitis, transient synovitis, and fractures may all present. This can be considered a diagnostic difficulty when both clinical presentations and abnormal radiographic findings are not traditional characteristics of leukemia patients [3]. Acute Lymphoblastic Leukemia (ALL) has a high rate of survival (92+/7%) if detected early [4].