Musculoskeletal manifestations caused by malignancies in children with various malignancies: a cross-sectional study in southeastern Iran.

Background: We aim to evaluate the prevalence and variety of musculoskeletal symptoms in pediatric oncologic patients in southeastern Iran, with the objective of enhancing our understanding of these disorders, particularly musculoskeletal manifestations caused by malignancies, increasing awareness among healthcare providers, and ultimately improving the quality of care for this patient population based on reliable epidemiological data. Materials and methods: This cross-sectional descriptive-analytical study was conducted on 200 children diagnosed with malignancy, with an average age of 6 years and 6 months, from 01 January 2021 to 31 December 2022. The researcher's checklist included demographic information, as well as all clinical, laboratory, and radiological signs, such as radiographic findings, ultrasound, MRI, and nuclear scans. The information was gathered from all patients with malignancies at Afzalipour Hospital in Kerman, Iran. Musculoskeletal manifestations were studied both as the initial manifestation of malignancies and as symptoms that occurred in the course of the disease. The results were compared and evaluated based on the research objectives. Results: The most common malignancies among children were ALL, lymphoma, and neuroblastoma. Forty-eight percent of children had musculoskeletal manifestations at the beginning of the disease, and the most common malignancy was ALL, followed by muscle sarcoma. The most prevalent musculoskeletal manifestation was bone pain in the long bones. The mean time from the onset of musculoskeletal manifestations at the beginning of the disease until the diagnosis was two months, which did not differ significantly from patients without musculoskeletal manifestations. The most frequent bone pain occurred in the lower extremities. Conclusion: Since musculoskeletal manifestations are the most common early signs of malignancies in patients outside the bone marrow, physicians need to pay special attention to these symptoms. A thorough history and physical examination, along with laboratory and radiological findings, can aid in the timely diagnosis of malignancies and improve the prognosis for these children.