Author: Lisa Fratt

Knee pain: Helping families access care

An Athletic boy Holding her Painful Injured Knee

Many parents don’t hesitate to bring their child to the emergency department (ED) for orthopedic injuries, including knee conditions. In fact, many head straight for the ED without contacting their child’s pediatrician or primary care provider. However, many common knee conditions can be managed in the primary care office.

Read on for an at-a-glance guide to managing knee pain, and learn how partnering with a pediatric orthopedic specialist can help you help your patients. See how a particularly challenging case led to surgical innovation. …Read More

Challenging case: ABC tumor of the cervical spine


The case

After sustaining an apparent neck injury during a routine soccer fall, a 12-year-old presented to a local hospital emergency room. An MRI was ordered and indicated an aneurysmal bone cyst (ABC) tumor in her cervical spine.

The patient was transferred from the local emergency room to the Boston Children’s Hospital Emergency Department.

A CT confirmed the original diagnosis and showed a fracture and erosion of her C-5 vertebra.

Guidelines for ABC tumors in long bones often recommend sclerotherapy prior to surgery. Initially, one recommendation was that the patient undergo sclerotherapy to shrink the tumor, and then undergo surgery to remove the remaining tumor in the future.

The patient was extremely active and eager to have surgery and begin rehabilitation. Her family asked for other options. …Read More

Challenging case: Enterovirus


On Oct. 3, 2014, Elisa Holt was nursing her six-month-old son Noah when she realized he wasn’t moving his feet, legs or toes. Panicked, she called her pediatrician at Garden City Pediatrics and was directed to Beverly Hospital.

“We are so thankful for the emergency room doctor [Dr. Munirah Qualls] who told us, ‘I don’t know. I’m going to send you to Boston Children’s Hospital.’”

Within 15 minutes, an ambulance arrived to rush Noah to Boston Children’s where the emergency department was on high alert for EV D-68.

A bedside spinal tap and initial lab results narrowed Noah’s diagnosis to either Guillain Barre Syndrome or a type of myelitis possibly caused by EV-D68. Both conditions can be treated with immunotherapy, so Noah’s doctors moved forward with treatment.

Then an MRI confirmed Acute Flaccid Myelitis (AFM), a disorder caused by inflammation of the spinal cord. “We don’t know if EV D68 is the cause of AFM. There’s epidemiologic evidence that suggests it is, but we don’t have hard data to suggest that’s the case,” explains Mark Gorman, MD, from the Boston Children’s Hospital Department of Neurology.

The unproven link between enterovirus and AFM is not the only mystery associated with the virus.

…Read More

Q+A: What you need to know about bridge-enhanced ACL repair

Screen Shot ACL repairIt’s not uncommon for physicians and patients to refer to ACL surgery as ACL repair. The current standard of care, however, does not repair a torn ACL. The surgeon removes the ends of the torn ACL and replaces the ligament with a tendon graft. It’s ACL reconstruction.

Bridge-enhanced ACL repair (BEAR) is a promising new approach to ACL surgery that uses a protein-enriched sponge to encourage the torn ends of an ACL to reconnect and heal.

Martha Murray, MD, Boston Children’s Hospital orthopedic surgeon, and a team of researchers have spent nearly 25 years developing the BEAR surgery. The U.S. Food and Drug Administration (FDA) approved a 100-patient clinical trial at Boston Children’s to see if the BEAR surgery is as effective as ACL reconstruction.

Murray answers some questions about her ACL research and the BEAR trial. …Read More

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