Musculoskeletal Ultrasound in Patients With Hematologic Malignancies

Musculoskeletal Ultrasonographic Findings in Patients With Hematologic Malignancies: A Diagnostic Imaging Study Protocol

This study evaluates the role and diagnostic value of musculoskeletal ultrasonography (MSUS) in adult patients with hematologic malignancies who present with musculoskeletal symptoms.

Hematologic malignancies (such as leukemia, lymphoma, and multiple myeloma) frequently involve the musculoskeletal system through bone marrow infiltration, bone destruction, or soft-tissue lesions. Musculoskeletal ultrasound is a non-invasive, radiation-free, and high-resolution imaging technique that allows real-time evaluation of joints, muscles, tendons, bursae, and superficial bone changes.

In this study, adult participants with confirmed blood cancers presenting with symptoms such as localized bone pain, joint swelling, muscle pain, or soft-tissue swelling will undergo a dedicated ultrasound examination of symptomatic areas. The study aims to characterize the patterns of musculoskeletal involvement (including cortical breaks, periosteal changes, soft-tissue masses, synovitis, and vascularity on Doppler imaging) and determine how these findings correlate with disease type, clinical presentation, and laboratory parameters.

Inclusion Criteria:

• Adult patients (aged 18 years or older) with a confirmed diagnosis of hematologic malignancy (leukemia, lymphoma, or multiple myeloma) established by bone marrow examination, histopathology, and/or immunophenotyping.
• Patients presenting with musculoskeletal symptoms and undergoing musculoskeletal ultrasonography for the assessment of musculoskeletal involvement at diagnosis or during follow-up.
• Patients willing and able to provide written informed consent.

Exclusion Criteria:

• Patients with a prior or concurrent solid organ malignancy with known skeletal metastasis.
• Patients with a history of major musculoskeletal trauma, orthopedic surgery, or active musculoskeletal infection affecting the examined region.
• Patients with other connective tissue diseases (e.g., systemic lupus erythematosus, systemic sclerosis).
• Patients with other inflammatory arthropathies (e.g., psoriatic arthritis, ankylosing spondylitis, reactive arthritis).
• Patients with incomplete clinical, laboratory, or follow-up data.
• Patients who decline to participate or withdraw consent.