Key clinical point: Orthopedic manifestations in children may be the primary presentation of ALL and should be cause for suspicion.

Major finding: A total of 22 patients (8.8%) presented primarily to the orthopedic department.

Study details: A retrospective study of 250 consecutive ALL cases evaluated to identify cases with musculoskeletal manifestations.

Disclosures: The authors reported that there was no outside funding source and that they had no conflicts.