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Acute leukaemia presenting with isolated bone pain
  1. Barry Scanlan1,
  2. Montasser Nadeem1,
  3. Martin Ryan1,
  4. Owen Smith2,
  5. Aengus O'Marcaigh2,
  6. David Coghlan1
  1. 1Department of Paediatrics, National Children's Hospital, Dublin, Ireland
  2. 2Department of Haematology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
  1. Correspondence to Dr Montasser Nadeem, Department of Paediatrics, National Children's Hospital, AMNCH, Tallaght, Dublin 24, Ireland; drnadeem.gad{at}gmail.com

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A previously healthy 6-year-old boy presented with a 2-week history of vague pain in his abdomen, arm, neck and legs, which became more localised to the right side of the neck and right tibial plateau. Over the 6 days prior to admission, nocturnal bone pain was recorded. He was also lethargic, irritable and felt warm; however, temperature >37.7°C was not documented. Intermittent limping was reported. Physical examination was unremarkable, apart from exquisite tenderness on right tibial tuberosity and severe neck …

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