Brivio et al reported risk factors for osteonecrosis in a pediatric patient with acute lymphoblastic leukemia (ALL). The authors are from institutions in Italy and The Netherlands.
Patient selection: pediatric patient with ALL
Percentage of patients with osteonecrosis: 18%
Osteonecrosis in pediatric patients with ALL is typically multifocal.
Risk factors for osteonecrosis:
(1) age >= 10 years of age (HR 10.3 to 11.2))
(2) high-risk ALL (HR 3.5 to 5.4)
(3) relapsed (HR 2.9)
A lesion on a convex surface of a joint surface shows a higher risk of deterioration. This is not seen with lesions on the concave surface or diaphysis.
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