Skeletal Manifestations of Acute Lymphoblastic Leukemia in Two Pediatric Cases

Introduction: Acute leukemia in the pediatric population can present with a variety of orthopedic symptoms and signs, which can lead to delay in diagnosis. We report two such cases that presented to the emergency department in our hospital- King Fahad Medical City-, Riyadh, Saudi Arabia. Objective: The aim of this paper is to put emphasis on the fact that skeletal manifestations may be the first clinical presentation in children suffering from Acute Lymphoblastic Leukemia. Method: The report describes two pediatric patients who presented to our emergency department primarily with musculoskeletal symptoms but later turned out to be suffering from acute lymphocytic leukemia. Conclusion: Acute lymphocytic leukemia in pediatric patients can present first to the orthopedic service with bone pain, and nonspecific radiographic features, including: osteopenia, localized bony irregularities and fractures. High index of suspicion is warranted to avoid the delays in the diagnosis of the disease.