Musculoskeletal manifestations of childhood malignancies: a systematic review and meta-analysis.

Background: Timely diagnosis of malignancies in children is very important. Knowing the clinical manifestations of malignancies help in timely diagnosis. The aim of this study is to investigate the prevalence of musculoskeletal manifestations of malignancies in children.

Methods: we searched the manuscript databases including Scopus, Web of science, Google scholar, Medline, and Cochrane for all studies in accordance with the relevant keywords. The nine-star Newcastle-Ottawa Scale (NOS) scoring system was employed to assess the methodological quality of all eligible studies. Statistical analysis was performed using the Comprehensive Meta-Analysis (CMA) software.

Results: Of 96 articles initially collected by database searching, 13 articles were eligible for the final analysis. The major musculoskeletal manifestations related to childhood malignancies include bone pain, bone swelling, bone tenderness, bone fracture, vertebral collapses, joint effusion and joint tenderness. Manifestations related to these malignancies also include septic arthritis-type symptoms, osteomyelitis-type symptoms, and osteomyelitis. The overall pooled prevalence of musculoskeletal manifestations in children suffering hematopoietic tumors (acute lymphoblastic leukemia and acute myeloid leukemia) was 32.1% (95%CI: 24.0-41.3%). The overall prevalence of musculoskeletal manifestations due to neuroblastoma was also 30.5% (95%CI: 19.2-44.9%). The rate of musculoskeletal manifestations due to other childhood cancers range from 23.5 to 80.3%.

Conclusion: A significant part of childhood malignancies are associated with musculoskeletal manifestations. Clinicians should carefully evaluate and closely follow children with musculoskeletal manifestations to timely diagnosing of malignancies.

Trial registration number: Not applicable.