An elderly patient with chronic myelomonocytic leukaemia developed severe bone pains and acute gonarthritis. Intravenously administered cytosine arabinoside brought dramatic relief of the bone pains and led to a rapid subsidence of the arthritis, without achieving haematological remission.

Occasionally, pain after disease or trauma develops only after a prolonged interval. Examples include late-onset pains which first occur months or years following a stroke, spinal cord lesion or amputation of a limb; a previously experienced pain that is recalled years later; and latent pain triggered for the first time by a further insult in the same area. Late-onset pains may develop graduall...