Childhood cancer may present with musculoskeletal symptoms that mimic the features of rheumatic diseases, especially juvenile idiopathic arthritis, Italian researchers say.

The overlap of symptoms in some cases has the potential to lead to misdiagnosis, diagnostic delay and inappropriate use of glucocorticoids and immunosuppressive drugs, they caution.

The researchers studied 1277 children newly diagnosed with a malignancy and 680 newly diagnosed with juvenile idiopathic arthritis (JIA).

A quarter of the children with cancer had musculoskeletal symptoms, and these symptoms were most common in those diagnosed with bone tumours, Langerhans histiocytosis, leukaemia, soft-tissue sarcoma and neuroblastoma.