The limping child: A manifestation of acute leukemia

Nine patients who presented to our institution with the chief complaint of a limp and no history of trauma were subsequently diagnosed with leukemia. A review of these patients identified clinical and laboratory findings that helped to establish the diagnosis. The presence of an antalgic gait with c omplaints of pain of variable intensity and duration, an irritable hip or k nee, a mild to moderate elevation in body temperature, lymphadenopathy, hep atosplenomegaly, an increased erythrocyte sedimentation rate, thrombocytope nia, anemia, decreased neutrophils, increased lymphocytes, or blast cells o n the peripheral blood smear should cause the physician to suspect leukemia in a limping child. Bone marrow biopsy confirms the diagnosis.