Brix N, et al. - Among children with leukemia, researchers delineated, in detail, arthropathy (arthritis/arthralgia) as the children’s laboratory results, misdiagnosis, and treatment before the diagnosis of acute lymphoblastic leukemia (ALL) and the diagnostic delay. Findings revealed that children with arthritis were more often misdiagnosed and treated with intraarticular steroid before the diagnosis of ALL compared to the children with arthralgia. These children also showed longer diagnostic delay, primarily as a consequence of a longer first doctor’s delay.

• Researchers performed a retrospective cohort study by reviewing records of 286 children aged 1–15 years diagnosed with ALL from January 1992 to March 2013.
• Twenty-six children with arthralgia and 27 children with arthritis were identified.
• The children, in majority, showed one or two joints involved (arthralgia 72%, arthritis 42%), and most often hips and knees.
• No report of morning stiffness was recognized.
• They noted inclusion of imaging of affected joints in the initial workup of 77% of children with ALL and arthropathy; 66% was abnormal.
• In 26%, misdiagnosis as JIA occurred; 71% of these children received treatment with intraarticular corticosteroids.
• For the children with arthritis, the diagnostic delay was 3 weeks longer than those with arthralgia (median 54 vs 36 days), primarily as a consequence of a longer first doctor’s delay.