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After multiple blood tests over a 25-day period, including five full blood counts and two normal blood films, a third blood film finally demonstrated blasts in keeping with acute leukaemia. We discuss a literature review of musculoskeletal manifestations of leukaemia and the often atypical presentations found.<\/jats:p>","DOI":"10.1136\/bcr-2016-215551","type":"journal-article","created":{"date-parts":[[2016,6,29]],"date-time":"2016-06-29T11:00:20Z","timestamp":1467198020000},"page":"bcr2016215551","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Femoral diaphyseal stress fracture as the initial presentation of acute leukaemia in an adolescent"],"prefix":"10.1136","volume":"2016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1545-692X","authenticated-orcid":false,"given":"Helen Emily","family":"Chase","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedics, Norfolk and Norwich University Hospital, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joe Hwong","family":"Pang","sequence":"additional","affiliation":[{"name":"University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anish Pradip","family":"Sanghrajka","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Norfolk and Norwich University Hospital, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,6,28]]},"reference":[{"key":"2025082800375207000_2016.jun28_1.bcr2016215551.1","unstructured":"UKALL2011 Protocol_version 3.0 1st October 2013. http:\/\/www.isrtcn.com\/ISRCTN64515327 (accessed 2nd June 2016)."},{"key":"2025082800375207000_2016.jun28_1.bcr2016215551.2","first-page":"186","article-title":"The orthopaedic presentation of acute leukaemia in childhood","volume":"83","author":"Chell","year":"2001","journal-title":"Ann R Coll Surg Engl"},{"key":"2025082800375207000_2016.jun28_1.bcr2016215551.3","doi-asserted-by":"crossref","first-page":"494","DOI":"10.2106\/00004623-198668040-00003","article-title":"Orthopaedic manifestations of leukemia in children","volume":"68","author":"Rogalsky","year":"1986","journal-title":"J Bone Joint Surg Am"},{"key":"2025082800375207000_2016.jun28_1.bcr2016215551.4","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b13e31815ff350"},{"key":"2025082800375207000_2016.jun28_1.bcr2016215551.5","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/S0030-5898(20)32108-8","article-title":"Orthopedic manifestations of acute pediatric leukemia","volume":"27","author":"Gallagher","year":"1996","journal-title":"Orthop Clin North Am"},{"key":"2025082800375207000_2016.jun28_1.bcr2016215551.6","doi-asserted-by":"publisher","DOI":"10.5812\/iranjradiol.6765"},{"key":"2025082800375207000_2016.jun28_1.bcr2016215551.7","doi-asserted-by":"publisher","DOI":"10.1080\/08880010802434818"},{"key":"2025082800375207000_2016.jun28_1.bcr2016215551.8","doi-asserted-by":"publisher","DOI":"10.1097\/01.bpo.0000173250.86634.0f"},{"key":"2025082800375207000_2016.jun28_1.bcr2016215551.9","doi-asserted-by":"crossref","unstructured":"Buckley SL , Robertson WW Jr , Shalaby-Rana E . 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