以单骨痛为首发症状的儿童急性白血病误诊原因分析OACSTPCD

Objective To explore the causes of misdiagnosis and preventive measures of acute leukemia(AL)in children with single bone pain as the initial symptom.Methods The clinical data of two children with AL misdiagnosed as osteomyelitis at initial visit and admitted to our hospital from January 2019 to December 2022 were retrospectively analyzed.Results At the initial diagnosis,all 2 patients presented with pain in the affected side of the lower limb,accompanied by fe-ver.Routine blood tests showed normal white blood cell counts,and 2 patients showed increased C reactive protein.After X-ray and MRI examinations,1 patient was misdiagnosed as acute tibia osteomyelitis,and 1 patient was misdiagnosed as acute femur osteomyelitis.The two patients were treated by operation,no obvious periosteal or intramedullary abscess was found dur-ing operation,and acute lymphoblastic leukemia was confirmed by postoperative pathological examination.Two patients were transferred to Department of Hematology for subsequent treatment,1 patient was in remission after treatment,and 1 patient was still receiving anti-tumor therapy.Conclusion AL in children with single bone pain as the initial symptom lacks specific clinical manifestations,and it is difficult to distinguish from bone and joint infectious diseases by imaging examination,which may lead to inappropriate treatment regimen.Understanding the clinical characteristics of the disease and performing bone marrow puncture examination when necessary are the key to reducing or avoiding misdiagnosis and mistreatment.