Osteosarcoma is one of the most prevalent primary malignant tumors in orthopedics and is most often seen in adolescents between the ages of 10-25. However, this is the age when bones are growing rapidly, and it is easy to mistake the pain caused by osteosarcoma as a normal physiological phenomenon – growing pains – and miss the best time for treatment. I. What are the diseases similar to growing pains? Fracture: Due to the high activity of children and immature bone development, it is easy to cause fracture. And babies around 3 years old are not quite able to express their feelings yet, so fracture is the most misdiagnosed item. Malignant osteoma: Malignant osteoma, also known as bone cancer, may occur due to factors such as genetics, radiation exposure, bone overgrowth, chronic inflammatory stimulation, specific viral infections and poor blood return in the bone. Childhood leukemia: The incidence of childhood malignancies is led by leukemia, which is misdiagnosed as growing pains because the bone marrow expands and the periosteum is stretched, causing pain in the bones, especially below the knee, and is often misdiagnosed as arthritis. Juvenile arthritis: Juvenile arthritis is easily misdiagnosed as growing pains because the patient feels pain when the joint is pressed; although muscle pain is the typical symptom of growing pains, young children cannot tell the difference between muscle pain and joint pain. Late onset rickets: For leg pain in children between the ages of 5 and 15, the disease can develop if there is a deficiency of vitamin D and calcium because children of this age are growing and have an increased need for vitamin D and calcium. Children suffering from this disease should pay attention to calcium supplementation. How to distinguish disease pain or growing pains? 1. Lower limb pain: Growing pains most commonly occur in the lower limbs, in the legs above and below the knee and ankle joints. Occasionally it is in the groin area, and the pain is usually outside the joints. Typically, the pain is bilateral, but there is also pain on one side, soreness or tingling that lasts for a few minutes and rarely more than an hour. 2. Muscular pain: Growing pains are mainly muscle pains, not joint or bone pains. There is also no redness, swelling or heat in the painful area, and it does not affect walking. 3.Night pain: Growing pains almost always occur at night. In fact, it is not that the pain does not occur during the day, but it is not easily noticeable because the child is more active during the day. When sleeping at night, the blood flow slows down and “stagnates”, and the pain will seem very obvious. 4.After rest, the symptoms of growing pains are usually relieved, but disease pains are difficult to improve through rest. 5.With the development, growing pains will gradually reduce to disappear, but patients with disease pains will show a gradual increase in pain, accompanied by movement disorders of limbs and joints. Growing pain is a normal physiological phenomenon and belongs to muscular pain, growing pain phenomenon is generally does not need special treatment. The most effective way to deal with painful episodes is to provide local massage and hot compresses for the child to help reduce the pain level and make the child feel psychologically cared for and secure. If you find that your child has unexplained leg pain, you should promptly take your child to a regular hospital for examination in order to prevent it as much as possible.