{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T20:16:53Z","timestamp":1776025013679,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T00:00:00Z","timestamp":1590796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012524","name":"American Lebanese Syrian Associated Charities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012524","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["CA21765"],"award-info":[{"award-number":["CA21765"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Osteonecrosis is a debilitating complication in children and adolescents with acute lymphoblastic leukemia or acute lymphoblastic lymphoma (LLy). An objective screening test to identify patients at risk for symptomatic, extensive joint involvement will help manage osteonecrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a prospective, longitudinal pilot study with whole\u2010joint magnetic resonance imaging (MRI) of shoulders, elbows, hips, knees, ankles, and hindfeet to evaluate the incidence and timing of osteonecrosis involving multiple joints in 15 patients with LLy aged 9\u201021\u00a0years at diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Osteonecrosis affecting \u226530% of the epiphysis occurred in eight of 15 patients, with a high prevalence in hips (12 of 26 examined [46%]) and knees (10 of 26 [38%]) post reinduction I and in shoulders (seven of 20 [35%]) post reinduction II. Most osteonecrotic hips and knees with \u226530% epiphyseal involvement became symptomatic and\/or underwent surgery (100% and 82%, respectively). All eight patients with \u226530% epiphyseal involvement had multijoint involvement. Seven of these patients had hip or knee osteonecrosis by the end of remission induction, and only these patients developed osteonecrosis that became symptomatic and\/or underwent surgery in their hips, knees, shoulders, ankles, and\/or feet; all of these joints were associated with epiphyseal abnormalities on post reinduction I imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>MRI screening in adolescent patients with LLy revealed osteonecrosis in multiple joints. Initial screening with hip and knee MRI at the end of induction may identify susceptible patients who could benefit from referrals to subspecialties, more extensive follow\u2010up imaging of other joints, and early medical and surgical interventions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28336","type":"journal-article","created":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T13:52:43Z","timestamp":1590846763000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Whole\u2010joint magnetic resonance imaging to assess osteonecrosis in pediatric patients with acute lymphoblastic lymphoma"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0605-7342","authenticated-orcid":false,"given":"Hiroto","family":"Inaba","sequence":"first","affiliation":[{"name":"Department of Oncology St Jude Children's Research Hospital  Memphis Tennessee"},{"name":"Department of Pediatrics University of Tennessee Health Science Center  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Varechtchouk","sequence":"additional","affiliation":[{"name":"Department of Oncology St Jude Children's Research Hospital  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Neel","sequence":"additional","affiliation":[{"name":"Department of Surgery St Jude Children's Research Hospital  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Ehrhardt","sequence":"additional","affiliation":[{"name":"Department of Oncology St Jude Children's Research Hospital  Memphis Tennessee"},{"name":"Department of Pediatrics University of Tennessee Health Science Center  Memphis Tennessee"},{"name":"Department of Epidemiology and Cancer Control St Jude Children's Research Hospital  Memphis 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K.","family":"Ness","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St Jude Children's Research Hospital  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raul C.","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Oncology St Jude Children's Research Hospital  Memphis Tennessee"},{"name":"Department of Pediatrics University of Tennessee Health Science Center  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0303-5658","authenticated-orcid":false,"given":"Ching\u2010Hon","family":"Pui","sequence":"additional","affiliation":[{"name":"Department of Oncology St Jude Children's Research Hospital  Memphis Tennessee"},{"name":"Department of Pediatrics University of Tennessee Health Science Center  Memphis 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