Acute leukaemia presenting with isolated bone pain

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 …