ArticlePediatric rheumatology online journal2020
Persistent osteoarticular pain in children: early clinical and laboratory findings suggestive of acute lymphoblastic leukemia (a multicenter case-control study of 147 patients).
Article in Pediatric rheumatology online journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 26 citations in OpenAlex.
- Clinical and Laboratory Indicators of Pediatric Leukemia and Neuroblastoma in Musculoskeletal Presentations: A Retrospective Study From a Resource-Limited Setting.European journal of haematology · 2026Article
- MRI paving the way to diagnosis of acute lymphoblastic leukemia in children and adolescents - a retrospective observational study.Molecular and cellular pediatrics · 2026Article
- Pain Experiences During Early Treatment for Pediatric Acute Lymphoblastic Leukemia: A Qualitative Study.Psycho-oncology · 2026Article
- Identifying the characteristics of and developing a predictive model for differentiating cancer-related musculoskeletal symptoms from juvenile idiopathic arthritis.Pediatric rheumatology online journal · 2025Article
- Differences between leukemic arthritis and juvenile idiopathic arthritis.Pediatric rheumatology online journal · 2023Article
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- Differential diagnosis portfolio of a pediatric rheumatologist: eight cases, eight stories.Clinical rheumatology · 2021Review
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Authors and funding
19 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to identify early clinical and laboratory features that distinguish acute lymphoblastic leukemia (ALL) from juvenile idiopathic arthritis (JIA) in children presenting with persistent bone or joint pain for at least 1 month.
methodsWe performed a multicenter case-control study and reviewed medical records of children who initially presented with bone or joint pain lasting for at least 1 month, all of whom were given a secondary diagnosis of JIA or ALL, in four French University Hospitals. Each patient with ALL was paired by age with two children with JIA. Logistic regression was used to compare clinical and laboratory data from the two groups.
resultsForty-nine children with ALL and 98 with JIA were included. The single most important feature distinguishing ALL from JIA was the presence of hepatomegaly, splenomegaly or lymphadenopathy; at least one of these manifestations was present in 37 cases with ALL, but only in 2 controls with JIA, for an odds ratio (OR) of 154 [95%CI: 30-793] (regression coefficient: 5.0). If the presence of these findings is missed or disregarded, multivariate analyses showed that non-articular bone pain and/or general symptoms (asthenia, anorexia or weight loss) (regression coefficient: 4.8, OR 124 [95%CI: 11.4-236]), neutrophils < 2 × 10
conclusionsBased on our findings we propose the following preliminary decision tree to be tested in prospective studies: in children presenting with at least 1 month of osteoarticular pain and no obvious ALL in peripheral smear, perform a bone marrow examination if hepatomegaly, splenomegaly or lymphadenopathy is present. If these manifestations are absent, perform a bone marrow examination if there is fever or elevated inflammatory markers associated with non-articular bone pain, general symptoms (asthenia, anorexia or weight loss), neutrophils < 2 × 10
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