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Miscellanea
Images in paediatrics
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. 1 Department of Paediatrics, National Children's Hospital, Dublin, Ireland
  2. 2 Department 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

https://doi.org/10.1136/archdischild-2013-304430

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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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    Footnotes

    • Contributors BS was involved in collecting data and writing the manuscript. MN was involved in writing the manuscript and drafting the article. MR was involved in reporting and interpretation the images. OS and AO'M were involved in diagnosis and management of the case; AO'M was also involved in drafting and writing the manuscript. DC was involved in diagnosis and management of the case. He was also involved in revising the article critically for important intellectual content and final approval of the version to be published.

    • Competing interests None.

    • Provenance and peer review Not commissioned; internally peer reviewed.