Iyer Aditi, Mangal Rohan, Stead Thor, Barbera Andrew
The Village School Houston, TX, USA.
University of Miami Miller School of Medicine, Miami, FL, USA.
Orthop Rev (Pavia). 2022 Aug 25;14(3):37419. doi: 10.52965/001c.37419. eCollection 2022.
The authors present a case of a 2-year-old girl with left ankle pain. On examination, there was tenderness but no sign of superficial swelling, erythema, or deformity. Imaging studies revealed a heterogeneous lytic lesion in the distal diaphysis of the left fibula, causing a pathologic fracture. The patient was treated with ankle splinting, analgesia, and referred to a pediatric orthopedic physician. Ultimately the diagnosis of acute lymphoblastic leukemia (ALL) was made. The authors present the significance of discerning skeletal abnormalities and orthopedic pain as the initial manifestation of leukemia.
作者报告了一例2岁女童左踝疼痛的病例。检查时，有压痛，但无浅表肿胀、红斑或畸形迹象。影像学检查显示左腓骨远端干骺端有一不均质溶骨性病变，导致病理性骨折。患者接受了踝关节夹板固定、镇痛治疗，并转诊至小儿骨科医生处。最终确诊为急性淋巴细胞白血病（ALL）。作者阐述了识别骨骼异常和骨科疼痛作为白血病初始表现的重要性。
