LEONARDTOWN, Md. – Orthopaedic surgeon William Lennen, MD, of MedStar Orthopaedic Institute at Leonardtown then tried another approach. With the imaging revealed by an MRI, the source of Jack’s pain was finally there in black and white: a cotton ball-sized cyst behind his knee.
“Cysts are very common, and most arise from either a joint or tendon sheath around the knee, wrist, or shoulder,” said Dr. Lennen. “Common cysts, like Baker’s cysts, form when fluid escapes a joint—analogous to a water balloon that fills when fluid from the joint is pumped into the cyst. They are benign in nature, so there is no cancer risk. They rarely cause issues but, if symptomatic, they can generally be removed relatively easily.”
During a Sept. 1 follow-up, Jack and his mother learned surgery would be needed to remove the tissue. With an unexpected opening in the operating schedule, the Meyers were surprised to hear Jack would head in for the procedure in just two days.
“It was a bit stressful,” laughed the teen. “Honestly, I was mostly nervous about the IV—I’d never needed one before. What made it better was the staff. They were pretty cool; it was fun to talk with them. They were patient.”
During the hour-long outpatient procedure at MedStar St. Mary’s Hospital, the Meyers awaited updates on their son. They learned Dr. Lennen was able to remove the cyst intact for testing.
“Most cysts, including Jack’s, are benign,” the surgeon explained. “If there is any concern for cancerous potential, the patient will receive further evaluation before surgery in the form of additional imaging. The tissue would then be reviewed by a pathologist.”
Jack went home that Friday and, by Sunday, the familiar sound of the teen’s basketball hitting blacktop had already returned to the air. He then began six weeks of physical therapy at MedStar Shah Medical Group in California to focus on movement and stretching.
During one session, Jack’s physical therapist made a surprising observation: his spine was curved. “Did you know that Jack has scoliosis?” the therapist asked Holly.
“Hm. Well, that would explain my back pain,” Jack noted drily.
Like his knee, the teen had experienced sporadic back pain for years—particularly after long periods of standing. As an active student who is often playing football, hiking, kayaking, and camping, the discomfort could get distracting.
Jack was quickly referred to spine specialist David A. Weiner, MD, a fellowship-trained orthopaedic spine surgeon with expertise in pediatric scoliosis and adult spinal deformities, among other conditions. He sees patients at many regional locations, including MedStar Orthopaedic Institute at Brandywine.
“Most children get diagnosed by a school nurse during a scoliosis screening, or by their pediatrician,” said Dr. Weiner. “Other patients may not be diagnosed until they come in for treatment of lower back pain and sciatica, only to find out it has been caused by their scoliosis.”
Defined as a curvature of the spine greater than 10 degrees, scoliosis can occur in both children and adults. The diagnosis can come as a surprise, as it did for the Meyers.
The Meyers took Jack for testing—this time an extensive MRI, with the results available to Dr. Weiner quickly through MedConnect, MedStar Health’s electronic health record. Thankfully, they revealed no additional concerns beyond the 13% left curvature.
“Dr. Weiner impressed me from the start,” Holly shared. “If there was one thing I sensed from the entire MedStar orthopaedic team, it would be how much they cared. The surgeons were accessible, and we got answers quickly. That was a big relief as a parent.”
She added it was “pretty wild that we went in thinking we were dealing with one small issue, the knee pain, and we came out with a resolution for that plus a diagnosis for scoliosis—something I didn’t even realize was a concern.”
Today, a tidy vertical scar is all that remains of Jack’s knee discomfort. The scoliosis will continue to be monitored every six months with additional physical therapy to help with back pain. In the meantime, the teen was cleared to compete on the Chopticon High School wrestling team this fall and winter. A 60-mile trek through the Rocky Mountains is planned for this summer, with shorter hikes in between.
The Meyers were impressed with the thoroughness and responsiveness of an orthopaedic team who clearly wanted to find answers for their son. And for his part, Jack bonded with Dr. Lennen over a shared love of football (though the surgeon roots for the Miami Dolphins; Jack is a diehard Cleveland Browns fan).
“It was easy to talk to him,” Jack added. “You can’t ask questions if you don’t feel comfortable.”