Referring Provider Newsletter

Reminder to Include Clinical Documentation When Sending Referrals

The scheduling team at Arkansas Children's Northwest would like to remind the referring provider community to include any necessary clinical documentation such as notes, growth charts or lab results when sending referrals. If you are a Healthy Planet Link account user, this information can be attached as documents during the referral creation process. Simply save the necessary attachments to your computer documents and click "Add Files" in the Order Entry screen.

Having this pertinent information assists schedulers and our specialty providers in being prepared for patients and allowing ample time for appointments. Please reach out to your Physician Liaison if you have any questions or need additional training.

EOS Low Dose Imaging Available

Arkansas Children's Hospital recently acquired EOS®, an innovative 2D/3D imaging system dedicated to orthopedic patients with osteoarticular pathologies.

The EOS system provides low dose or Micro Dose, full body, images of adult and pediatric patients respectively in a weight bearing, functional position. The bi-planar device includes two perpendicular fan beams of X-rays and proprietary detectors that travel vertically while scanning the patient’s full body or an anatomical region of interest. In less than 20 seconds, the EOS exam produces two simultaneous bi-planar (frontal and lateral) low dose images of the whole body or an anatomical segment, without magnification.

The EOS system delivers 50% to 85% less dose than digital radiography and 95% less dose than computed tomography (CT). The Micro Dose protocol is ideal for pediatric patients, particularly those who require frequent imaging. Micro Dose further reduces radiation levels and allows us to capture a frontal and lateral full spine at a dose equivalent to only a week’s worth of natural radiation.

To refer a pediatric ortho patient for EOS imaging, call 501-364-4000.

Time is Critical for Success with a Cranial Remolding Helmet

Orthotics and Prosthetics at Arkansas Children's Hospital has experts trained in the assessment of cranial deformities in infants. Because cranial remolding is a growth directed process, there is a short window of opportunity for successful outcomes.

Babies are often referred too late to effectively correct head shape by the use of a CRO (cranial remolding orthosis) as it is believed they will grow out of it. About 30% will grow worse instead of better. Very often, by the time they see an orthotist, the rapid growth phase has ended. At least 2 to 3 cm of circumferential growth is needed to see a significant change using a CRO. This is best achieved while the skull is most malleable prior to 6 months of age. Three months gestational age is a perfect time to evaluate if there is any concern regarding head shape. By 12 months of age, the amount of change that can be achieved is imperceptible.

There is no fee to see an orthotist for the assessment of positional cranial deformities. There is only a charge when a cranial remolding orthosis (CRO) is provided. Deformities suspected of being caused by craniosynostosis, should be referred to a surgeon as soon as possible. X-rays provide limited information for early fusion of cranial sutures. A CT scan is the gold standard needed for a formal diagnosis. In these cases, please refer directly to our APRN for plastic surgery to rule out craniosynostosis and refer them to orthotics.

At the appointment, an orthotist will take an image using an eye safe laser cranial scanner as part of the initial assessment to determine if a CRO is needed. If we see the babies early enough (3 months gestational age), we will likely wait, scan again a month later and track changes in shape before making any recommendation for a CRO. Cranial remolding therapy is regulated by the FDA. CROs are class 2 medical devices which may only worn between the gestational ages of 3 months and must be removed by 18 months of age. We do not recommend fitting with a helmet beyond 10 or 11 months as the amount of correction will be minimal. The later we begin therapy, the less we can correct. Physicians can refer to Orthotics and Prosthetics by writing a prescription for a cranial remolding orthosis
(diagnosis code Q67.3).

If you would like any resources, study citations, general information or a subject matter presentation, please call 501-364-1192 or email us at orthotics@archildrens.org.

New Providers

• Maher AbulFaraj Emergency Medicine
• Zain Alamarat, MD, FAAP Infectious Disease
• Jon Bos, PhD Psychology (Neuropsychology)
• Courtney Cox, MD Critical Care
• Jurhee Freese, MD Endocrinology
• Aixa Gonzalez Garcia, MD Genetics
• Jorge Geurrero, MD Anesthesiology
• Jordan Gross, MD Orthopedics-Spine
• Ebaa Jastaniah, MD Emergency Medicine 
• Erica Liebelt, MD PEM/TOX
• Daniel Mak, MD Endocrinology
• Renita Mak, MD PEM 
• Phoebe Martin, MD Gen Peds
• Kristin Mitchell, MD Hospital Medicine
• Cindy Nguyen, MD Hospital Medicine
• Lauren Poindexter, MD UAMS Ortho Sports Medicine ACNW
• Jenny Pratt, CRNA Anesthesiology-CRNA
• Max Schilling, MD Anesthesiology
• Charles Runyan III, MD Radiology

View April 2021 Newsletter View February 2021 Newsletter