Magnetic resonance imaging of a pediatric case of arthritis associated with acute lymphoblastic leukemia: A case report

In the present case report, a 3-year-old girl presented with a 1-week history of spontaneously resolving right knee pain. After 1 month, the patient had trouble ambulating due to painful swelling of their ankle. Rheumatic disease, specifically juvenile idiopathic arthritis, was considered. Blood exa...

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Bibliographic Details
Published inExperimental and therapeutic medicine Vol. 24; no. 4
Main Authors Fujita, Yuji, Kuwashima, Shigeko, Kato, Tamae, Sato, Megumi, Ishikawa, Makoto, Sato, Yuya, Yoshihara, Shigemi
Format Journal Article
LanguageEnglish
Published Athens Spandidos Publications 01.10.2022
Spandidos Publications UK Ltd
D.A. Spandidos
Subjects
Ankle
Arthritis
Blood
Bone marrow
Case Report
Case reports
Case studies
Diagnosis
Leukemia
Lymphocytic leukemia
Magnetic resonance imaging
Osteoarthritis
Patients
Pediatric research
Pediatrics
Physiological aspects
Rheumatic diseases
Japan
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Summary:In the present case report, a 3-year-old girl presented with a 1-week history of spontaneously resolving right knee pain. After 1 month, the patient had trouble ambulating due to painful swelling of their ankle. Rheumatic disease, specifically juvenile idiopathic arthritis, was considered. Blood examination could not be conducted because their blood sample was coagulated. [T.sub.1]-weighted magnetic resonance imaging (MRI) revealed abnormally low signals in the femur, tibia, fibula and foot bone marrow. Contrast-enhanced [T.sub.1]-weighted MRI revealed synovial contrast enhancement and synovial fluid retention in the right ankle joint. Blood analysis revealed a white blood cell count of 40,000/[micro]l (blasts, 66%). In addition, a monoclonal increase in the number of lymphoblasts was observed. The patient was subsequently diagnosed with B-cell precursor acute lymphoblastic leukemia. Reports on leukemic arthritis resembling synovitis on MRI remain limited. The findings of this report indicated that pediatricians should consider leukemia in children presenting with joint symptoms. Key words: acute lymphoblastic leukemia, juvenile idiopathic arthritis, magnetic resonance imaging, diaphysis signal intensity, rheumatic disease
ISSN:1792-0981
1792-1015
DOI:10.3892/etm.2022.11561