ACUSON Sequoia™ Ultrasound System Developmental Dysplasia (DDH) of the Pediatric Hip Job Aid | VA30 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 ( only or  + ) displayed on the Touch Screen and report in the System Configuration menu of the VA30A software release for the ACUSON Sequoia™ 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. Beginning the Exam Step 1 Select compatible transducer1 and MSK preset. Step 2 Obtain the desired hip image. 90º 270º Step 3 Rotate the image if needed. Rotating the image allows for matching of the hanging protocol for hip radiographs. Update Callper clip Step 4 Press the Caliper key at Homebase to activate the measurement package. Step 5 Exam Package Select Ped Hip from the Exam Package menu. Ped Hip Step 6 Tap the laterality label (Right or Left). Step 7 Right Left Choose the desired measurement (Hip Angle, Stressed %FHC, Flexed %FHC). Hip Angle ( a) Stressed %FHC Flexed %FHC 1 Linear transducers allow imaging of the Pediatric Hip and activation of the measurement package. 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 June 2021 | HOOD/HILS05162003196976 Job Aid | DDH of the Pediatric Hip Effective Date: 21 June 2021 | HOOD/HILS05162003196976 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 Tap the Touch Screen measurement to activate the desired hip tool. Step 2 Choose Right or Left from the Touch Screen. Step 3 Rotate and place the baseline parallel to the iliac (solid line) with the arrow towards the femoral head. Step 4 Press Set to anchor the baseline.  Step 5 Align the  line to the bony roof of the acetabulum (dotted line). Step 6 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 Choose Right or Left from the Touch Screen. Step 3 Rotate and place the baseline parallel to the iliac (solid line) with the arrow towards the femoral head. Step 4  Press Set to anchor the baseline. Step 5 Orient the  line to the acetabular roof (dotted line). Step 6  Align the  line to the bony acetabulum (dashed line). Step 7 Select Set a second time to place measurements in the report. SIEMENS Healthineers Job Aid | DDH of the Pediatric Hip Effective Date: 21 June 2021 | HOOD/HILS05162003196976 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) with the arrow towards the femoral head. 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). A solid vertical line indicates the healthy value of greater than 60° for the  angle and lower than 55° for the  angle. Sonometer 45 GRAF 3 6 9 12 WEEKS 50,55 Ill a/b 80 75 65 60 45 CRITICAL ZONE 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 | DDH of the Pediatric Hip Effective Date: 21 June 2021 | HOOD/HILS05162003196976 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 collec- tively “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 nec- essarily 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 cau- tions. 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 commercially 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 authority. Of- fenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. ACUSON Sequoia 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