Finding the zebra: Primary care that is anything but routine

Finding the zebra: Primary care that is anything but routine

Joseph Nych, 17, enjoys playing soccer and baseball.

Most parents know that routine pediatric care is important for the health of their little ones. But many may not realize that these appointments can actually be life-changing. Jon and Cathleen Nych know firsthand how the conscientious and knowledgeable care from the pediatricians at University Hospitals Rainbow Babies & Children’s Hospital can make a difference. Without it, their son Joseph would not be living the full life he enjoys today.

Extraordinary care

Cathleen delivered Joseph, the youngest of four children, 17 years ago. The family’s pediatrician, Naser Danan, MD, primary care pediatrician at Northeast Pediatrics in Willoughby – part of the UH Rainbow Care Network – visited the hospital the morning after the birth to examine Joseph. But when Dr. Danan felt Joseph’s hips, he detected a slight dislocation – a subtle issue that is often and easily missed.

“I vividly recall how I felt examining Joseph. Although not a common problem – I have seen only about five cases in my 26 years of practice – we are trained to look for it,” recalls Dr. Danan. “I knew something was not right.”

Dr. Danan referred the couple to a UH Rainbow Babies & Children’s Hospital pediatric orthopaedist for specialty care. An ultrasound confirmed that Joseph had hip dysplasia.

“Dr. Danan explained the problem was not life-threatening but needed our attention quickly,” says Jon. “Because he had the knowledge and education to discover this so early, it changed everything.”

Changing lives

“I trained at UH Rainbow Babies & Children’s Hospital, where they taught us to look for the ‘zebra’ – the something different.” – Naser Danan, MD

Hip dysplasia occurs when the head of the femur, or leg bone, does not sit correctly in the hip socket. Typically, babies like Joseph who are born with the problem have not yet fully formed the cup of the hip socket. If left untreated, the head of the femur grows outside the socket.

“Joseph’s problem was caught the day after birth and we were on a treatment path that very week. Because babies’ bones grow so quickly, delaying treatment even a few months would have been damaging,” explains Cathleen.

When not caught and treated early, hip dysplasia can cause permanent damage to the hip joint, leading to limping and leg pain for life. In addition, treatment options with a delayed diagnosis are more invasive, involving surgery and rigid bracing.

Instead, Joseph wore a soft harness for the first few months of life, which held his femur bone in place while the socket cup grew around it. After only three months, Joseph’s hip dysplasia was completely gone and he required no other treatment.

Finding the zebra

“In medicine, we often deal with common health problems. But we must always look for the unexpected,” explains Dr. Danan. “I trained at UH Rainbow Babies & Children’s Hospital, where they taught us to look for the ‘zebra’ – the something different.”

Dr. Danan continues, “Having a medical home with a trusted pediatrician is so important. When care is fragmented, such as skipping well-child appointments or going to urgent care centers for routine care, that is when the zebras are missed.”

Today, photos of Joseph in the soft harness are the only reminders that the 17-year-old had hip dysplasia. The active teen lives a normal life, enjoying soccer, baseball and other sports.

“We cannot say enough about Dr. Danan. He always has his radar up, yet is so grounded,” explains Cathleen, whose family still sees the pediatrician. “Sometimes, it is that one little thing that can make all the difference. We are so blessed for the care we have received.”

I ❤ my Rainbow doctor

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With more than 200 pediatric and family medicine doctors at more than 70 community locations, your family has access to top-notch primary care for kids, close to home. To find a Rainbow doctor, call 216-UH4-KIDS (216-844-5437) or visit

Naser Danan

Primary Care Pediatrician, Northeast Pediatrics
Clinical Instructor, Case Western Reserve University School of Medicine

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