{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T19:04:23Z","timestamp":1788721463582,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T00:00:00Z","timestamp":1644364800000},"content-version":"vor","delay-in-days":39,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We aimed to evaluate the utility of plain X\u2010ray radiograph (PXR) findings in suggesting a diagnosis of acute leukemia in children presenting with bone pain in the emergency department (ED) of a children\u2019s hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using our radiology reporting system and registered data for childhood acute leukemia, we collected data regarding patients who underwent musculoskeletal PXR examinations in the ED due to bone pain in their extremities, from March 1, 2002 to June 30, 2015. We retrospectively reviewed their PXR findings and clinical information from the electronic medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,331 patients underwent PXR examinations and in 12 PXR findings showed suspected acute leukemia. From the registered data we found 12 acute leukemia patients who underwent emergency extremity PXR. Ten patients were finally confirmed to have acute leukemia by bone marrow examinations. The most common finding was lucent metaphyseal bands, demonstrated in seven cases, whereas six patients did not show any abnormalities in their peripheral blood cell counts. Sensitivity and specificity values of PXR for acute leukemia diagnosis were 90.0% and 99.8%, respectively. Positive predictive value and negative predictive values were 75.0% and 99.9%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Plain X\u2010ray radiograph is a useful diagnostic tool to detect possible acute leukemia in patients presenting with bone pain, earlier than abnormalities of their peripheral blood cell counts. Our results implied the possibility of re\u2010examining PXRs in acute leukemia more carefully, even when there are no abnormalities in blood cell counts.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.14843","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T10:09:55Z","timestamp":1621246195000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Utility of emergent plain X\u2010ray for childhood acute leukemia with bone pain"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4662-6415","authenticated-orcid":false,"given":"Ai","family":"Ito","sequence":"first","affiliation":[{"name":"Children\u2019s Cancer Center National Center for Child Health and Development (NCCHD) Tokyo Japan"},{"name":"Center for Postgraduate Education and Training NCCHD Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoo","family":"Osumi","sequence":"additional","affiliation":[{"name":"Children\u2019s Cancer Center National Center for Child Health and Development (NCCHD) Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6136-4903","authenticated-orcid":false,"given":"Kentaro","family":"Fujimori","sequence":"additional","affiliation":[{"name":"Children\u2019s Cancer Center National Center for Child Health and Development (NCCHD) Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Tomizawa","sequence":"additional","affiliation":[{"name":"Children\u2019s Cancer Center National Center for Child Health and Development (NCCHD) Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5145-1774","authenticated-orcid":false,"given":"Motohiro","family":"Kato","sequence":"additional","affiliation":[{"name":"Children\u2019s Cancer Center National Center for Child Health and Development (NCCHD) Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency and Transport Services NCCHD Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5340-3781","authenticated-orcid":false,"given":"Kimikazu","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Children\u2019s Cancer Center National Center for Child Health and Development (NCCHD) Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Ishiguro","sequence":"additional","affiliation":[{"name":"Children\u2019s Cancer Center National Center for Child Health and Development (NCCHD) Tokyo Japan"},{"name":"Center for Postgraduate Education and Training NCCHD Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1793-4892","authenticated-orcid":false,"given":"Osamu","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Radiology NCCHD Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.13457"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-311251"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b13e31815ff350"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)80535-9"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1516-31802005000100005"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2011.02230.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-18832-9_19"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004694-199809000-00014"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428199609054810"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-009-1221-0"},{"key":"e_1_2_7_12_1","first-page":"3","article-title":"Musculoskeletal manifestations in children with acute lymphoblastic leukaemia","volume":"3","author":"Mulder H","year":"2012","journal-title":"Belg. 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