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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. 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}

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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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