ACUSON Sequoia™ Ultrasound System Developmental Dysplasia (DDH) of the Pediatric Hip Job Aid | VA25 Software Release

Developmental Dysplasia (DDH) of the Pediatric Hip This document helps you use ultrasound to determine neonatal hip development through recognition of anatomic landmarks and measurements. Customize the measurements displayed on the touch screen and report in the System Configuration menus on the ACUSON Sequoia™ ultrasound system with the VA25A software. Sonographic Anatomy Coronal / Neutral View C 1. Cartilaginous femoral head (yellow) 2. Triradiate cartilage and bony ilium junction (green) * 3. Bony acetabulum or acetabular roof (red) 4. Labral fibrocartilaginous tip (open arrow) 5. Greater trochanter (asterisk) 6. Synovial fold (double arrowhead) 7. Femoral metaphysis (blue) This image of the right hip demonstrates normal anatomy of the pediatric hip. C – cephalad; L – lateral. Acquire images demonstrating all anatomic landmarks to ensure measurement accuracy. SIEMENS Unrestricted Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2021 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: 21 06 2021 | HOOD/HILS05162003196963 Job Aid | DDH of the Pediatric Hip Effective Date: 21 06 2021 | HOOD/HILS05162003196963 Measurements  only The intersection of the baseline, placed parallel to the ilium, and a second line posi- - tioned along the acetabular labrum creates the  angle. The resulting value reflects the depth of the bony acetabular roof. Step 1 Tap the Touch Screen measurement to activate the desired hip tool. Step 2 Rotate and place the baseline parallel to the iliac (solid green line). Step 3 Press Set to anchor the baseline. Step 4  Align the  line to the bony roof of the acetabulum (dotted line). Step 5 Select Set a second time to place the measurement in the report.  and  The intersection of the baseline, placed parallel to the ilium, and a second line positioned - along the acetabular labrum creates the  angle. The resulting value reflects the depth of the bony acetabular roof. The angle formed by the baseline and the bony acetabulum (roof) is the  angle. This - helps determine femoral head coverage by the acetabulum. Step 1 Tap the Touch Screen measurement to activate the desired hip tool. Step 2 Rotate and place the baseline parallel to the iliac (solid line).  Step 3 Press Set to anchor the baseline. Step 4 Align the  line to the bony acetabulum (red dashed line). Step 5  Orient the  line to the acetabular roof (orange dotted line). Step 6 Select Set a second time to place measurements in the report. SIEMENS Healthineers Job Aid | DDH of the Pediatric Hip Effective Date: 21 06 2021 | HOOD/HILS05162003196963 Femoral Head Coverage (FHC) The percentage of the femoral head which lies within the acetabulum. - Step 1 Tap the Touch Screen measurement to activate the desired hip tool. Step 2 Rotate and place the baseline parallel to the iliac (solid line). Step 3 Press Set to anchor the baseline. Step 4 Position and size the circle to fit the femoral head (dotted circle). Step 5 Select Set a second time to place in the report. FHC = Length A / Length B Length A (red arrow) = measurement from the posterior edge of the femoral head to the baseline Length B (blue arrow) = measurement of the femoral head posterior to anterior Graphing  and  Values The Sonometer displays a marker corresponding to the  angle (top horizontal line) and / or the  angle (bottom horizontal line). The healthy value of greater than 60° for the  angle and lower than 55° for the  angle is indicated by the solid vertical line. Sonometer GRAF ? 3 6 9 12 50 55 WEEKS 60 557ºc Ill a/b 80 75 CRITICAL ZONE 65 60 55   Type I  60°  55° Type II* 43 - 50° < 70° Type III#  42° > 77° *Includes Type IIa, Type IIb, and Type IIc #Includes Type IIIa and Type IIIb SIEMENS Healthineers Job Aid | DDH of the Pediatric Hip Effective Date: 21 06 2021 | HOOD/HILS05162003196963 References: Graf, R. (1984). Classification of hip joint dysplasia by means of sonography. Archives of Orthopedic and Traumatic Surgery; 102:248-255. Graf, R., Mohajer, M.A., & Plattner, F. (2013). Hip sonography update. Quality-management, catastrophes-tips and tricks. Medical Ultrasonography; 15(4):299-303. Please note that the learning material is for training purposes only! Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current For the proper use of the software or hardware, please always use the Op- information. erator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as The reproduction, transmission or distribution of this training or its con- training material only and shall by no means substitute the Operator Man- tents is not permitted without express written authority. Offenders will be ual. Any material used in this training will not be updated on a regular ba- liable for damages. sis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. ACUSON Sequoia is a registered trademark of Siemens Medical Solutions USA, Inc. Note: Some functions shown in this material are optional and might not be part of your system. All rights, including rights created by patent grant or registration of a util- ity model or design, are reserved. Certain products, product related claims or functionalities (hereinafter col- lectively “Functionality”) may not (yet) be commercially available in your Copyright © Siemens Healthcare GmbH 2021 country. Due to regulatory requirements, the future availability of said …………………………………………………………………………………………………………………………………………………………………………………. Siemens Healthineers Headquarters Legal Manufacturer & Published by Siemens Healthcare GmbH Siemens Medical Solutions USA, Inc. 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