Do Not Dismiss Persistent Knee Pain In Children; It Could Be Bone Cancer, Doctor Cautions

KUALA LUMPUR, Aug 28 (Bernama) -- Parents, coaches and sports trainers are advised not to dismiss persistent knee pain in children as a common sports injury or simply ‘growing pains’, as it could be an early warning sign of osteosarcoma, an aggressive form of bone cancer.

Osteosarcoma commonly affects children and adolescents, with approximately 75 per cent of cases occurring before the age of 25. The annual incidence rate stands at 4.4 cases per million people.

Dr Tie Teck Liang, an Orthopaedic Oncology Surgeon at Sunway Medical Centre in Bandar Sunway, said osteosarcoma typically develops around the knee, making its symptoms easy to mistake for sports-related injuries, often leading to delayed diagnosis.

"Normally, pain from a sports injury will subside with rest and painkillers. However, if the pain persists for more than two weeks, remains severe, or no longer responds to pain medication, immediate medical attention is necessary," he said in a statement.

He added that it is more important to observe the pattern rather than the level of pain, especially if the pain wakes the child up at night, or is accompanied by a lump, swollen leg, or limping without any obvious cause.

Commenting on the challenges of detecting osteosarcoma at an early stage, Dr Tie said that unlike ordinary tissue injuries, cancerous tumours can grow rapidly in a child's body and involve nearby nerves and blood vessels, making treatment more complex.

"An X-ray is the first step in evaluating persistent bone pain, as it can reveal abnormal bone changes and help doctors determine the next course of action," he said.

He added that if suspicious changes appear on the X-ray, further imaging such as an MRI may be needed to determine the size of the tumour and its position in relation to nearby nerves and blood vessels.

Dr Tie also cautioned that a biopsy, or tissue sample collection, must be carefully planned and ideally performed by the same surgeon who will carry out the patient's definitive surgery, to minimise the risk of tissue contamination.

"A poorly planned biopsy can contaminate surrounding tissues, complicate the reconstruction process, increase the risk of cancer recurrence, and raise the likelihood that the limb may need to be amputated," he explained.

He said advancements in treatment now make limb-sparing surgery possible for selected cases, including through biological reconstruction methods such as cryotherapy.

In this procedure, the affected section of the patient's bone is removed and treated with liquid nitrogen at minus 196 degrees Celsius to destroy the cancer cells, before the bone is re-implanted.

"The advantage is that we use the patient's own bone, which reduces issues like size mismatch and supports natural bone healing in certain cases.

"For children, this approach can also help minimise leg length discrepancies and preserve long-term function," he said.

He added that the overall treatment and recovery process, including chemotherapy and surgery, can take about a year. However, early diagnosis is crucial to improving the chances of limb preservation and enabling patients to return to an active and normal life.

-- BERNAMA

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