In the summer of 2023, a Maryland child’s cancer was initially overlooked as growing pains.

Holohan M. Boy, 11, diagnosed with stage 4 cancer after doctor said his hip pain was from growing. TODAY.com. September 17, 2024.

The then-11-year-old—who is now in remission for anaplastic large cell lymphoma, a rare type of non-Hodgkin lymphoma—had been experiencing aches and pain in his hip, according to TODAY.com.

Cleveland Clinic. Anaplastic Large Cell Lymphoma. August 10, 2022.

Holohan M. Boy, 11, diagnosed with stage 4 cancer after doctor said his hip pain was from growing. TODAY.com. September 17, 2024.

The pain kept him up at night—at times causing tears—and also occurred during the day. When the pain didn’t go away with time, the child’s parents explored more options, taking their son to a sports medicine doctor,  an oncologist, and then a rheumatologist. It was the rheumatologist who provided the diagnosis: Through a bone biopsy, the expert concluded that the child was not experiencing growing pains, but stage 4 non-Hodgkin lymphoma.

The child received six rounds of chemotherapy. He is now in remission.

Being wary about growing pains

The Hospital for Special Surgery, the world’s leading academic medical center focused on musculoskeletal health, says, “It is important for doctors to distinguish these [growing] pains from other pain that may deserve further investigation.”

Hospital for Special Surgery. Growing Pains. May 8, 2023.

A child’s aches and pain may not be related to growing pains and could be something more serious, including if the pain is accompanied by:

• Visible signs of illness or injury

• Fever

• Rash

• Weight loss

• Joint swelling

• Stiffness, especially after waking up

• Redness

• Limping

• Inability to participate in typical activities

• Worsening pain during the daytime

• Limited range of motion

• Loss of appetite

Aches and pain accompanied by any of the above should be medically evaluated quickly in order to determine the cause of the pain, according to HSS. Further testing is also important for those showing concerning symptoms during a physical examination. 

“Pain accompanied by fever, a rash or loss of appetite should prompt an immediate visit to the child’s doctor,” the HSS recommends. “A more serious problem can be misdiagnosed as growing pains, and if a child is experiencing persistent pain.”

Pain in one leg but not the other is also a sign to see a doctor, according to the National Health Service (NHS) of the United Kingdom.

NHS UK. Growing pains.

It can also be important to stay on the lookout for other severe pediatric conditions—in addition to non-Hodgkin lymphoma—that could be misdiagnosed as growing pains.

Hospital for Special Surgery. Growing Pains. May 8, 2023.

According to the HSS, some of these include:

• Bone diseases

• Bone lesions

• Bone cancer (osteosarcoma) 

• Soft-tissue sarcoma

• Amplified Musculoskeletal Pain Syndrome

• Lyme disease

• Osgood-Schlatter disease

• Juvenile lupus (SLE)

• Cartilage injuries and disorders

• Ligament injuries

• Tendon injuries and conditions

• Sports injuries

• Shin splints

• Stress fractures