Bone and Joint Pain in Leukemia, Simulating Acute Rheumatic Fever and Subacute Bacterial Endocarditis

ALTHOUGH pain along the bones and in the joints in the acute leukemias has been reported in the literature from time to time, its diagnostic significance has not been sufficiently stressed, and its confusion with acute rheumatic fever has been the rule rather than the exception. This confusion has depended to a large extent upon the many similarities in the symptomatology of the leukemias and rheumatic fever. In either of these conditions there may be asthenia, palpitation, dyspnea on exertion, epistaxis, fever, bone and joint pain, abdominal pain, pallor, purpuric manifestations, lymphadenopathy, splenomegaly, anemia, tachycardia, accentuation of the heart sounds . . .