Musculoskeletal manifestations of childhood cancer and differential diagnosis with juvenile idiopathic arthritis (ONCOREUM): a multicentre, cross-sectional study

Civino, Adele; Alighieri, Giovanni; Prete, Eleonora Del; Caroleo, Anna Maria; Magni‐Manzoni, Silvia; Vinti, Luciana; Romano, Micol; Santoro, Nicola; Filocamo, G; Belotti, Tamara; Santarelli, Francesca; Gorio, Chiara; Ricci, Francesca; Colombini, Antonella; Pastore, Serena; Cesaro, Simone; Barone, Patrizia; Verzegnassi, Federico; Olivieri, Alma Nunzia; Ficara, Monica; Miniaci, Angela; Russo, Giovanna; Gallizzi, Romina; Pericoli, Roberta; Breda, Luciana; Mura, Rossella; Podda, Rosa Anna; Onofrillo, Daniela; Lattanzi, Bianca; Tirtei, Elisa; Maggio, Maria Cristina; Santis, R. De; Consolini, Rita; Arlotta, A; Torre, Francesco La; Mainardi, Chiara; Pelagatti, Matteo; Coassin, Elisa; Capolsini, Ilaria; Burnelli, Roberta; Tornesello, Assunta; Soscia, Francesca; Fanti, Alessandro De; Rigante, Donato; Pizzato, Cristina; Fusco, Carmela; Abate, Massimo Eraldo; Roncadori, Andrea; Rossi, Elisa; Stabile, Giulia; Biondi, Andrea; Lepore, Loredana; Conter, Valentino; Rondelli, Roberto; Pession, Andrea; Ravelli, Angelo; Amatruda, Matilde; Atzeni, C; Bertolini, Patrizia; Bigucci, Barbara; Caniglia, Maurizio; Cappella, Michela; Cattalini, Marco; Cefalo, MG; Cellini, Monica; Cortis, Elisabetta; Davì, Sergio; Benedetti, Fabrizio; Cataldo, Andrea Di; Fabbri, Erich; Fontanili, I; Garaventa, Anna Accarino; Gicchino, Maria Francesca; Ladogana, Saverio; Locatelli, Franco; Magnolato, Andrea; Marsili, Manuela; Martino, Silvana; Mascarin, Maurizio; Messina, C; Micalizzi, Concetta; Porta, Fulvio; Rizzari, Carmelo

doi:10.1016/s2665-9913(21)00086-2

Cited by 13 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6 A markedly elevated ESR with normal CRP (so-called "acute phase reactants discordance") was seen, a finding that has been shown to represent a possible element of suspicion for neoplastic conditions but can also occur in rheumatologic or inflammatory conditions. 3,7 In conclusion, our report confirms that periodic fever can be a presenting feature of ALL in children, particularly if it is accompanied by joint pain. Given the protean presentation of leukemia in childhood, the presence of atypical clinical and laboratory signs should always prompt a peripheral blood smear with flow cytometry and, eventually, a bone marrow aspiration.…”

Section: Discussionsupporting

confidence: 78%

“…First of all, although children with ALL can present with insidious stories of protracted and often smoldering symptoms, this patient presented with periodic symptoms (ie, distinct recurrent episodes of acute symptoms, including fever and joint pain, followed by relatively long periods of complete well-being) that may have initially misled clinicians. Although fever is a common presenting symptom in children with ALL, 3 periodic fever as a presenting symptom of ALL has rarely been reported. The only report, by Koffeman et al, 4 described the case of a girl with ALL presenting with periodic fever accompanied by nonlocalized musculoskeletal pain and severe anemia.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A “SURFin’ Leukemia”: Acute Lymphoblastic Leukemia Masquerading as a Syndrome of Undifferentiated Recurrent Fever

De Nardi,

D’Agostin,

Naviglio

et al. 2023

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

Periodic fever is not uncommon in childhood and is often ascribed to autoinflammatory conditions; however, it may be present also in children with cancer. We here describe the case of a 3-year-old boy with acute lymphoblastic leukemia who initially presented with a 4-month history of recurrent, stereotyped episodes of fever and localized joint pain, separated by completely symptom-free intervals. These symptoms were initially interpreted as a possible syndrome of undifferentiated recurrent fever until more signs of leukemia became apparent. Our report confirms that acute lymphoblastic leukemia can rarely present with periodic fever, thus possibly leading to diagnostic errors unless a high index of suspicion is maintained.

show abstract

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

A “SURFin’ Leukemia”: Acute Lymphoblastic Leukemia Masquerading as a Syndrome of Undifferentiated Recurrent Fever

De Nardi,

D’Agostin,

Naviglio

et al. 2023

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

show abstract

“…The reported number of attendances in primary and secondary care found in the literature was 4.6 (range 1-12) and 3 (0-12), respectively, (28,31). We have previously shown a median of (20). In the present study, we did not find arthropathy as a presenting manifestation in brain tumors.…”

Section: Discussionsupporting

confidence: 45%

“…Musculoskeletal misdiagnoses have primarily been described in children with leukemia and lymphomas, (18,21), and only a few cases of musculoskeletal misdiagnoses in children with brain tumors have been described. (20,22,23). A recently published nationwide registry-based cohort study by our group, including all children with cancer in Denmark over 23 years, identified a musculoskeletal diagnosis prior to the diagnosis of cancer in 4% (33/931) with brain tumors, (19).…”

Section: Introductionmentioning

confidence: 99%

“…Brain tumors have rarely been described with musculoskeletal symptoms other than gait disturbances or neck pain, (14)(15)(16)(17). Though, considering the whole spectrum of childhood cancers, musculoskeletal symptoms at debut have been found in up to 25% and musculoskeletal diagnoses in 7-12%, (18)(19)(20). Musculoskeletal misdiagnoses have primarily been described in children with leukemia and lymphomas, (18,21), and only a few cases of musculoskeletal misdiagnoses in children with brain tumors have been described.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Musculoskeletal misdiagnoses in children with brain tumors: A nationwide, multicenter case-control study

Hallundbæk¹,

Hagstrøm²,

Mathiasen

et al. 2022

Preprint

View full text Add to dashboard Cite

Objective Childhood brain tumors belong to the cancer type with the longest diagnostic delay, the highest health care utilization prior to diagnosis, and the highest burden of long-term sequelae. We aimed to clarify whether prior musculoskeletal diagnoses in childhood brain cancer were misdiagnoses and whether it affected the diagnostic delay. Study design In this retrospective, chart-reviewed case-control study we compared 28 children with brain tumors and a prior musculoskeletal diagnosis to a sex and age-matched control group of 56 children with brain tumors and no prior musculoskeletal diagnosis. Using the Danish registries, the cases were identified from consecutive cases of childhood brain cancers in Denmark over 23 years (1996-2018). Results Of 931 children with brain tumors, 3% (28/931) had a prior musculoskeletal diagnosis, of which 39% (11/28) were misdiagnoses. The misdiagnoses primarily included torticollis-related diagnoses which tended to a longer time interval from first hospital contact until a specialist was involved: 35 days (IQR 6-166 days) compared to 3 days (IQR 1-48 days), p = 0.07. When comparing the 28 children with a prior musculoskeletal diagnosis with a matched control group without a prior musculoskeletal diagnosis, we found no difference in the non-musculoskeletal clinical presentation, the diagnostic time interval, or survival. Conclusion Musculoskeletal misdiagnoses were rare in children with brain tumors and did not affect the diagnostic time interval or survival. The misdiagnoses consisted primarily of torticollis- or otherwise neck-related diagnoses.

show abstract

Approach to Musculoskeletal Pain in Children

Gupta,

Patra

2023

Indian J Pediatr

View full text Add to dashboard Cite

Musculoskeletal manifestations of childhood cancer and differential diagnosis with juvenile idiopathic arthritis (ONCOREUM): a multicentre, cross-sectional study

Cited by 13 publications

References 24 publications

A “SURFin’ Leukemia”: Acute Lymphoblastic Leukemia Masquerading as a Syndrome of Undifferentiated Recurrent Fever

A “SURFin’ Leukemia”: Acute Lymphoblastic Leukemia Masquerading as a Syndrome of Undifferentiated Recurrent Fever

Musculoskeletal misdiagnoses in children with brain tumors: A nationwide, multicenter case-control study

Approach to Musculoskeletal Pain in Children

Contact Info

Product

Resources

About