5). Partial or full bursectomies wereperformed in all patients with symptomatic spurs orrecurrent triceps tendonitis in which evidence of concom-itant bursitis was found at operation. 2,14 The spur wasgenerally covered by at least a thin layer of triceps tendon,which was incised longitudinally.
In children older than 10 years, the most common cause of limping is ankle sprain (Sty et al.). Overuse syndromes are caused by microtrauma; examples of overuse syndromes are stress fracture, Osgood-Schlatter disease, shin splints, Sever's disease, and chondromalacia patellae.
Acute limping in children is a common reason for consultation in pediatric emergency units. Acute leukemia is a rarely encountered disease in the orthopedic surgeon's activity. In addition, its clinical presentation is not typical and therefore is a source of possible diagnostic delay. For such reasons, there is a definite risk of undiagnosing the actual etiology of the limping episode. We report our experience with four cases of children initially seen in the pediatric emergency department for limping, as their revealing presentation of acute leukemia.