ACUSON Redwood™ Ultrasound System VE10F Software Developmental Dysplasia (DDH) of the Pediatric Hip Job Aid

ACUSON Redwood™ Ultrasound System Job Aid | DDH of the Pediatric Hip VE10F Software Release Effective Date: DD MM 2021 | HOOD/HILSTBD Developmental Dysplasia (DDH) of the Pediatric Hip Job Aid siemens-healthineers.com/ultrasound This document helps you use ultrasound to determine neonatal hip development through recognition of anatomic landmarks and measurements. Customize the measurements ( only or +) displayed on the Touch Screen and report in the System Configuration menu of the VA10F software release for the ACUSON Redwood™ ultrasound system. Sonographic Anatomy Coronal / Neutral View C L 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: 08 November 2021 | HOOD/HILS05162003228181 Job Aid | ACUSON Redwood System VE10F Software DDH of the Pediatric Hip Effective Date: 08 November 2021 | HOOD/HILS05162003228181 Beginning the Exam Step 1 Select compatible transducer1 and MSK preset. Update Step 2 clip Obtain the desired hip image. Freeze. ABC Step 3 Press the Caliper key (orange highlight) at Homebase to activate the measurement package. Step 4 Workflow From the Workflow tab, located on the upper right of the Touch Screen, select Pediatric. Pediatric Step 5 E Select Ped Hip on the Touch Screen. Ped Abdomen Ped Hip Step 6 Tap the laterality label (Right, Left, None). Right Left None Step 7 Choose the desired measurement (Hip Angle, Stressed %FHC, Flexed %FHC). Rt Hip Angle Rt Stressed %FHC Rt Flexed %FHC 1 Linear transducers allow imaging of the Pediatric Hip and activation of the measurement package. Measurements  only 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. Step 1 Update Caliper Obtain the desired hip image. Freeze. Step 2 ABC Press the Caliper key (orange highlight) at Homebase to activate the measurement package. Step 3 Fa Choose Right or Left. The  line appears. Hip (a) Step 4 Update Move the trackball (orange highlight) to adjust the baseline. ABC SIEMENS Healthineers Job Aid | ACUSON Redwood System VE10F Software DDH of the Pediatric Hip Effective Date: 08 November 2021 | HOOD/HILS05162003228181 Measurements  only - continued Rotate Step 5 Rotate and place the baseline parallel to the iliac (solid line). Step 6 Press Set to anchor the baseline. Step 7 Align the  line to the bony roof of the acetabulum (dotted line). Step 8  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 bony - acetabulum (roof) is the  angle. This helps determine femoral head coverage by the acetabulum. A second line positioned along the acetabular labrum creates the  angle. The resulting value reflects the - depth of the bony acetabular roof. Step 1 Obtain the desired image, Freeze, and tap the Touch Screen measurement to activate the hip tool. Step 2 Press the Caliper key at Homebase to activate the measurement package. Step 3 Choose Right or Left and Hip (+ ) from the Touch Screen. Hip (B+a) Step 4 Move the trackball to adjust the baseline. Step 5 Rotate and place the baseline parallel to the iliac (solid line). Step 6 Press Set to anchor the baseline.  Step 7 Align the  line to the bony acetabulum (dashed line).  Step 8 Press Set to anchor the  line. Step 9 Orient the  line to the acetabular roof (dotted line). Step 10 Select Set a second time to place measurements in the report. SIEMENS Healthineers Job Aid | ACUSON Redwood System VE10F Software DDH of the Pediatric Hip Effective Date: 08 November 2021 | HOOD/HILS05162003228181 Femoral Head Coverage (FHC) The percentage of the femoral head which lies within the acetabulum. - Ped Abdomen Ped Hip Step 1 Obtain the desired hip image. Freeze. Right Left None Step 2 Press the Caliper key at Homebase to activate the Lt Hip Angle Lt Stressed %FHC measurement package. Lt Flexed %FHC Step 3 Tap the Touch Screen measurement to activate the d:D desired hip tool (Stressed %FHC, Flexed%FHC). %FHC Step 4 Choose the d:D %FHC soft key located at the bottom of the Touch Screen. Step 5 Rotate and place the baseline parallel to the iliac (solid line). Step 6 Press Set to anchor the baseline. Step 7 Position and size the circle to fit the femoral head (dotted circle). Step 8 Select Set a second time to place in the report. Femoral Head Coverage (FHC) - Ratio Step 1 Obtain the desired hip image. Freeze. Step 2 Press the Caliper key at Homebase to activate the measurement package. Step 3 d:D Tap the Touch Screen measurement to activate the d:D Ratio desired hip tool (Stressed %FHC, Flexed%FHC). Step 4 Ped Abdomen Ped Hip Choose the d:D Ratio soft key located at the bottom of the Touch Screen. Right Left None Step 5 Place the first caliper at the posterior femoral head. Step 6 Lt Hip Angle Lt Stressed %FHC Lt Flexed %FHC 50 % Press Set to anchor. SIEMENS Healthineers Job Aid | ACUSON Redwood System VE10F Software DDH of the Pediatric Hip Effective Date: 08 November 2021 | HOOD/HILS05162003228181 Femoral Head Coverage (FHC) - Ratio continued Step 7 Position the second caliper at the anterior femoral head. Step 8 Position the third caliper at the posterior femoral head. Step 9 Select Set. Step 10 Position the fourth caliper at the midpoint of the femoral head. Step 11 Select Set to place the measurement 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 SIEMENS Healthineers Job Aid | ACUSON Redwood System VE10F Software DDH of the Pediatric Hip Effective Date: 08 November 2021 | HOOD/HILS05162003228181 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. To place the measured angles in a graph: Step 1 Ped Abdomen Ped Hip Obtain desired image and Freeze. Right Left None Step 2 Tap Caliper at Home Base. Rt Hip Angle Rt Stressed %FHC Rt Flexed %FHC Step 3 Tap Left or Right and corresponding hip angle on the touch screen. Hip () is now active. Va Hip (a) Step 4 Tap Hip (+). Step 5 Hip (B+a) Perform measurement.  Check the display of the  and  angles on the system monitor to ensure identification of situs (Rt or Hip Angle  Rt Hip Angle Lt) and measurement placement in the Sonometer. B B a a To view the measured angles in the Sonometer: Step 1  Tap Report. Step 2 Click Right Hip Sonometer for the right hip or Left Hip Sonometer for the left hip. Step 3 Sonometer Choose Right or Left 4540 /45, GRAF Q 3 6 9 5015560 557ºc 12 WEEKS Sep 4 Sle Ill a/b 80 75 CRITICAL ZONE 65 60 55 50   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 | ACUSON Redwood System VE10F Software DDH of the Pediatric Hip Effective Date: 08 November 2021 | HOOD/HILS05162003228181 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! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be com- mercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written au- thority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. ACUSON Redwood is a registered trademark of Siemens Medical Solutions USA, Inc. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH 2021 …………………………………………………………………………………………………………………………………………………………………………………. Siemens Healthineers Headquarters Legal Manufacturer & Published by Siemens Healthcare GmbH Siemens Medical Solutions USA, Inc. Henkestr. 127 Ultrasound 91052 Erlangen, Germany 22010 S.E. 51st Street Telephone: +49 9131 84-0 Issaquah, WA 98029, USA siemens.com/healthineers Phone: +1-888-826-9702 siemens-healthineers.com/ultrasound SIEMENS Healthineers