The Usefulness of T1-Weighted Magnetic Resonance Images for Diagnosis of Acute Leukemia Manifesting Musculoskeletal Symptoms prior to Appearance of Peripheral Blood Abnormalities
The patients with acute leukemia occasionally present with musculoskeletal symptoms initially, including bone pain, joint pain, muscular pain, and functional impairment. Without abnormal findings of peripheral blood cell counts or smear, the correct diagnosis tends to be delayed. Magnetic resonance...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2016/2802596 |
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| author | Toshihide Yoshikawa Akihiko Tanizawa Koji Suzuki Nanae Tanaka Taihei Hayashi Masayo Tsuda Genrei Ohta Naoko Kikuchi Hiroyuki Okamoto Takehiko Sakai Yoshihiro Taniguchi Yusei Ohshima |
| author_facet | Toshihide Yoshikawa Akihiko Tanizawa Koji Suzuki Nanae Tanaka Taihei Hayashi Masayo Tsuda Genrei Ohta Naoko Kikuchi Hiroyuki Okamoto Takehiko Sakai Yoshihiro Taniguchi Yusei Ohshima |
| author_sort | Toshihide Yoshikawa |
| collection | DOAJ |
| description | The patients with acute leukemia occasionally present with musculoskeletal symptoms initially, including bone pain, joint pain, muscular pain, and functional impairment. Without abnormal findings of peripheral blood cell counts or smear, the correct diagnosis tends to be delayed. Magnetic resonance imaging is often performed to examine musculoskeletal abnormalities; it can simultaneously reveal the bone marrow composition with high anatomical resolution and excellent soft tissue contrast. We present 4 pediatric patients who were initially diagnosed with acute pyogenic osteomyelitis or arthritis, based on the elevated white blood cell counts and/or C-reactive protein in addition to the localized high signal intensity on T2-weighted magnetic resonance images. Finally, they were diagnosed with B-cell precursor acute lymphoblastic leukemia by bone marrow examination. The period between the onset of musculoskeletal symptoms and the diagnosis of leukemia ranged from 20 days to 6 months. In all cases, the T1-weighted magnetic resonance images taken prior to detection of peripheral blood abnormality revealed diffuse low signal intensity of the bone marrow in regions adjacent or contralateral to localized musculoskeletal symptoms. These findings should raise the suspicion of leukemia even without abnormalities in peripheral blood. |
| format | Article |
| id | doaj-art-515ea1b68d84452db76087bdcdf2854b |
| institution | Kabale University |
| issn | 2090-6803 2090-6811 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-515ea1b68d84452db76087bdcdf2854b2025-08-20T03:36:38ZengWileyCase Reports in Pediatrics2090-68032090-68112016-01-01201610.1155/2016/28025962802596The Usefulness of T1-Weighted Magnetic Resonance Images for Diagnosis of Acute Leukemia Manifesting Musculoskeletal Symptoms prior to Appearance of Peripheral Blood AbnormalitiesToshihide Yoshikawa0Akihiko Tanizawa1Koji Suzuki2Nanae Tanaka3Taihei Hayashi4Masayo Tsuda5Genrei Ohta6Naoko Kikuchi7Hiroyuki Okamoto8Takehiko Sakai9Yoshihiro Taniguchi10Yusei Ohshima11Department of Pediatrics, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Pediatrics, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Pediatrics, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Pediatrics, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Pediatrics, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Pediatrics, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Pediatrics, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Pediatrics, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Pediatrics, Japan Community Health Care Organization, Kanazawa Hospital, 8-15 Okimachi, Kanazawa 920-0013, JapanDepartment of Pediatrics, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui 910-0846, JapanDepartment of Pediatrics, Japanese Red Cross Fukui Hospital, 2-4-1 Tsukimi, Fukui 918-8011, JapanDepartment of Pediatrics, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanThe patients with acute leukemia occasionally present with musculoskeletal symptoms initially, including bone pain, joint pain, muscular pain, and functional impairment. Without abnormal findings of peripheral blood cell counts or smear, the correct diagnosis tends to be delayed. Magnetic resonance imaging is often performed to examine musculoskeletal abnormalities; it can simultaneously reveal the bone marrow composition with high anatomical resolution and excellent soft tissue contrast. We present 4 pediatric patients who were initially diagnosed with acute pyogenic osteomyelitis or arthritis, based on the elevated white blood cell counts and/or C-reactive protein in addition to the localized high signal intensity on T2-weighted magnetic resonance images. Finally, they were diagnosed with B-cell precursor acute lymphoblastic leukemia by bone marrow examination. The period between the onset of musculoskeletal symptoms and the diagnosis of leukemia ranged from 20 days to 6 months. In all cases, the T1-weighted magnetic resonance images taken prior to detection of peripheral blood abnormality revealed diffuse low signal intensity of the bone marrow in regions adjacent or contralateral to localized musculoskeletal symptoms. These findings should raise the suspicion of leukemia even without abnormalities in peripheral blood.http://dx.doi.org/10.1155/2016/2802596 |
| spellingShingle | Toshihide Yoshikawa Akihiko Tanizawa Koji Suzuki Nanae Tanaka Taihei Hayashi Masayo Tsuda Genrei Ohta Naoko Kikuchi Hiroyuki Okamoto Takehiko Sakai Yoshihiro Taniguchi Yusei Ohshima The Usefulness of T1-Weighted Magnetic Resonance Images for Diagnosis of Acute Leukemia Manifesting Musculoskeletal Symptoms prior to Appearance of Peripheral Blood Abnormalities Case Reports in Pediatrics |
| title | The Usefulness of T1-Weighted Magnetic Resonance Images for Diagnosis of Acute Leukemia Manifesting Musculoskeletal Symptoms prior to Appearance of Peripheral Blood Abnormalities |
| title_full | The Usefulness of T1-Weighted Magnetic Resonance Images for Diagnosis of Acute Leukemia Manifesting Musculoskeletal Symptoms prior to Appearance of Peripheral Blood Abnormalities |
| title_fullStr | The Usefulness of T1-Weighted Magnetic Resonance Images for Diagnosis of Acute Leukemia Manifesting Musculoskeletal Symptoms prior to Appearance of Peripheral Blood Abnormalities |
| title_full_unstemmed | The Usefulness of T1-Weighted Magnetic Resonance Images for Diagnosis of Acute Leukemia Manifesting Musculoskeletal Symptoms prior to Appearance of Peripheral Blood Abnormalities |
| title_short | The Usefulness of T1-Weighted Magnetic Resonance Images for Diagnosis of Acute Leukemia Manifesting Musculoskeletal Symptoms prior to Appearance of Peripheral Blood Abnormalities |
| title_sort | usefulness of t1 weighted magnetic resonance images for diagnosis of acute leukemia manifesting musculoskeletal symptoms prior to appearance of peripheral blood abnormalities |
| url | http://dx.doi.org/10.1155/2016/2802596 |
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