{"pk":47307,"title":"A Case Report of Acute Lymphoblastic Leukemia Presenting as Bilateral Knee Pain in a Healthy Runner","subtitle":null,"abstract":"

Introduction: Acute lymphoblastic leukemia (ALL) is typically a childhood disease but may present in older patients in rare occurrences. Due to its significant morbidity and mortality, early diagnosis is crucial. The symptoms of ALL may be non-specific, making the initial diagnosis difficult leading to delayed treatment.

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Case Report: We present the case of a 34-year-old, healthy male runner presenting to the emergency department with a common complaint of bilateral knee pain, who was ultimately diagnosed with ALL with signs of tumor lysis syndrome leading to premature death.

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Conclusion: We discuss the presenting symptoms of acute lymphoblastic leukemia, which may include joint or knee pain as well as leukemic arthritis. We further discuss the importance of clinicians maintaining a high level of suspicion for the “bounce-back” patient and avoiding taking cognitive shortcuts.

","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"knee pain"},{"word":"acute lymphocytic leukemia"},{"word":"tumor lysis syndrome"},{"word":"spontaneous intracranial hemorrhage"},{"word":"Critical care"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7jx7d00h","frozenauthors":[{"first_name":"Michael","middle_name":"","last_name":"Rosselli","name_suffix":"","institution":"Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, Florida","department":""},{"first_name":"Alejandro","middle_name":"Jesus","last_name":"Sanoja","name_suffix":"","institution":"University of Florida, Department of Emergency Medicine, Gainesville, Florida","department":""},{"first_name":"Matthew","middle_name":"","last_name":"Apicella","name_suffix":"","institution":"Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, Florida","department":""}],"date_submitted":"2025-04-26T10:01:58.312000-04:00","date_accepted":"2025-08-27T15:56:35.229000-04:00","date_published":"2026-01-06T02:38:00-05:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/47307/galley/48085/download/"}]}