ACUSON Maple 1.0 Pediatric Hip Quick card

.thilili Job Aid Pediatric Hip ACUSON Maple Ultrasound System Software Release 1.0 siemens-healthineers.com/maple Healthmeets Two-dimensional (2D) ultrasound evaluation of the neonatal hip utilizing sonographic landmarks and measurement workflow. Sonographic Anatomy Coronal View Neutral C 1. Cartilaginous part of the 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 arrow-head) 7. Femoral metaphysis (blue) Tip: Acquire 2D images demonstrating all anatomic This image of the right hip demonstrates normal anatomy of the pediatric hip. C = cephalad; L = lateral. landmarks to ensure measurement accuracy.1 SIEMENS Healthineers . Beginning the Pediatric Hip Examination Step 1 Select an appropriate linear transducer and applicable musculoskeletal or Ped Hip preset Step 2 Obtain the desired hip image and Freeze * Step 3 Press the Caliper key on the control panel to activate the measurement x ... x Caliper Step 4 From the Exam tab, located on the bottom right-hand side of Exam Pediatrics the Touch Screen, select Pediatrics + Note: When using the Ped Hip preset, skip this step Step 5 Right Left None Select a measurement label indicating laterality Right, Left or None Rt Hip Angle Rt Flexed FHC Rt Stressed FHC Step 6 Select the labeled Hip Angle and desired tool to start the measurement Exam and • All linear transducers support the Ped Hip measurement. Rotate Size Workflow Tips: • The Ped Hip preset automatically activates the measurement package. • Move intersecting lines with the trackball and freely align the intersecting lines to the ultrasound anatomy with the Edit Rotate knob. Set Set • Edit the circle tool with the Size knob. • During measurement, the trackball keys appear at the bottom center of the monitor. • Advance through the Ped Hip measurement with the Set keys (highlighted in orange). 2 siemens-healthineers.com/maple Hip α Measurement Step 1 Obtain the desired hip image in Ped Hip preset and press Freeze Step 2 Press the Caliper key on the Control Panel to activate the Ped Hip measurements X ... x Caliper Step 3 Right Left None Select a measurement label indicating laterality Right, Left or None Rt Hip Angle Rt Flexed FHC Rt Stressed FHC Step 4 Select the labeled Hip Angle and then Hip α tool; the α line appears Hip (a) Step 5 Rotate Use the Rotate knob to align the baseline parallel to the ilium and crossing into the femoral head (line 1), press the Set key (highlighted in orange) to anchor the baseline Step 6 Align the α line to the acetabulum roof (line 2) using the Rotate knob, press the Set key (highlighted in orange) to anchor the α line Step 7 Press the Set key (highlighted in orange) to place in the 2 alpha angle into the Patient Report 1 siemens-healthineers.com/maple 3 Hip α+β Measurement Step 1 Obtain the desired hip image in Ped Hip preset and press Freeze Step 2 Press the Caliper key on the Control Panel to activate the Ped Hip measurements X ... x Caliper Step 3 Right Left None Select a measurement label indicating laterality Right, Left or None Rt Hip Angle Rt Flexed FHC Rt Stressed FHC Step 4 Select the labeled Hip Angle Hip (a+B) Step 5 To activate, tap the Hip α+β tool from the Touch Screen; the α line appears Step 6 Rotat Use the Rotate knob to align the baseline parallel to the iliac (line 1), press the Set key (highlighted in orange) to anchor the baseline Step 7 Orient the α line to the acetabular roof (line 2) using the Rotate knob, press the Set key (highlighted in orange) to anchor the α line Step 8 Align the β line to the bony acetabulum (line 3) using the 3 Rotate knob, press the Set key (highlighted in orange) to 2 anchor the β line ...... Step 9 .................................................... ................. 1 Press the Set key (highlighted in orange) to place the α and β angles into the Patient Report . ...... 4 siemens-healthineers.com/maple Hip β+α Measurement Step 1 Obtain the desired hip image in Ped Hip preset and press Freeze Step 2 Press the Caliper key on the Control Panel to activate the Ped Hip measurements X ... x Caliper Step 3 Right Left None Select a measurement label indicating laterality Right, Left or None Rt Hip Angle Rt Flexed FHC Rt Stressed FHC Step 4 Select the labeled Hip Angle and then Hip β+α tool from the Touch Screen; the β line appears Hip (B+a) Step 5 Rotate Align the baseline parallel to the iliac (line 1) with the Rotate knob, press the Set key (highlighted in orange) to anchor the baseline Step 6 Align the β line to the bony acetabulum (line 2) with the Rotate knob, press the Set key (highlighted in orange) to anchor the β line Step 7 Orient the α line to the acetabular roof (line 3) with the 2 Rotate knob, press the Set key (highlighted in orange) 3 to anchor the α line Step 8 + ................................................................................................. 1 Press the Set key (highlighted in orange) to place the β and α angles into the Patient Report siemens-healthineers.com/maple 5 Percent Femoral Head Coverage (% FHC) Step 1 Obtain the desired hip image in Ped Hip preset and press Freeze Step 2 Press the Caliper key on the Control Panel to activate the Ped Hip measurements X ... x Caliper Step 3 Right Left None Select a measurement label indicating laterality Right, Left or None Rt Hip Angle Rt Flexed FHC Rt Stressed FHC Step 4 Choose either labeled Flexed FHC or Stressed FHC on the Touch Screen Step 5 d:D Tap to activate the d:D % FHC tool on the Touch Screen %FHC Step 6 Rotat Align the baseline parallel to the iliac (yellow line) using the Rotate knob, press the Set key (highlighted in orange) to anchor the baseline Step 7 Position and size the circle to fit the femoral head (dotted circle); edit using the Size soft key, press the Set key (highlighted in orange) to anchor the circle Step 8 Press the Set key (highlighted in orange) to place the % FHC into the Patient Report Tip: Flexed FHC or Stressed FHC automatically defaults to the % FHC tool. Right Left None Rt Hip Angle Rt Flexed FHC Rt Stressed FHC 6 siemens-healthineers.com/maple Femoral Head Coverage (FHC) – Ratio Step 1 Obtain the desired hip image in Ped Hip preset and press Freeze Step 2 Press the Caliper key to activate the measurement package X ... x Caliper Step 3 Right Left None Select a measurement label indicating laterality Right, Left or None Rt Hip Angle Rt Flexed FHC Rt Stressed FHC Step 4 Choose either Flexed FHC or Stressed FHC on the Touch Screen Step 5 Tap to activate the d:D Ratio tool from the Touch Screen d:D Step 6 Ratio Place the first caliper at the posterior femoral head 2 (caliper 1); press the Set key (highlighted in orange) to anchor and the second caliper appears 4 Step 7 Position the second caliper at the anterior femoral head .......................................... + (caliper 2); press the Set key (highlighted in orange) to 1 3 anchor and the third caliper appears Step 8 Position the third caliper at the posterior femoral head (caliper 3); press the Set key (highlighted in orange) to anchor and the fourth caliper appears Step 9 Step 10 Position the fourth caliper at the femoral head and Select the Set key (highlighted in orange) to place the femoral neck axis, press the Set key (highlighted in FHC Ratio of d:D into the Patient Report orange) to anchor completing the FHC Ratio siemens-healthineers.com/maple 7 Image Rotation Step 1 Activate the Rotate Image control from the Touch Screen or the soft keys. Image Rotation from the Touch Screen is the default setting. Image Rotation may also be assigned to a soft key rotary knob under System Configuration > Soft Keys Step 2 -90 º 90 0 Choose 90°, 0° or -90° Rotate Image 90 Step 3 Select the desired hip measurement and complete as previously described • Rotate 90° RA Powvel 101 Depth indicator along the top of the image with the TI3 0.2 nearfield on the right-hand side of the field of view (FOV) • Rotate 0° Pod Op Standard orientation with the nearfield at the top and the depth indicators along the right-hand side of the FOV • Rotate -90° Depth indicator along the top of the image with the nearfield on the left-hand side of the FOV DTCC Med Dyr 8 07 de 15 pm Note: Ped Hip measurement tools rotate with the 2D image. Image Rotation is active on all linear transducers. Image Rotation is available during live imaging and is not available in Trapezoid, Dual mode or while magnified using Zoom. 8 siemens-healthineers.com/maple Definitions and Values The Graf method The Graf method is a well established ultrasound method for evaluating 2D measurements on infants aged less than six months and at an increased risk of developmental hip dysplasia.1–4 Hip α Angle The intersection of the baseline placed parallel to the ilium, and the second line, positioned along the acetabular labrum creates the alpha, or α angle. The resulting value reflects the depth of the bony acetabular roof. Hip α+β Workflow measuring the alpha followed by the beta angle. The alpha angle value reflects the depth of the bony acetabular roof. The angle formed by the baseline and the bony acetabulum (roof) is the beta angle, or β angle. This helps determine femoral head coverage by the acetabulum. Hip β+α Workflow measuring the beta followed by the alpha angle. The β angle helps determine femoral head coverage by the acetabulum and the alpha angle reflects the depth of the bony acetabular roof. % Femoral Head Coverage (%FHC) The percentage of the femoral head which lies within the acetabulum. Femoral Head Coverage (FHC) – Ratio The percentage of femoral head to the posterior offset from the femoral neck axis. 90° or -90° Image Rotation Rotating the 2D ultrasound image allows for matching to the hanging protocol for hip radiographs. Graphing α and β Values The Sonometer displays on the bottom right side of the image monitor and in the Patient Report once the hip Sonometer GRAF Q 6 12 WEEKS 35 50 55 60 65 70 measurement is complete. The top horizontal line on the 1ªma Sonometer represents the alpha angle and the bottom ill a/b horizontal line represents the beta angle. CRITICAL ZONE 70 For example: The solid yellow line on this Sonometer denotes a measurement within the healthy range for aangle 60º Bangle 55º both alpha and beta angles. Type I values indicate a healthy alpha angle which is 60° or greater and a healthy α β beta angle is 55° or less. Review the chart shown to the right for more information about Type II and Type III Type I ≥ 60° ≤ 55° alpha and beta values.3,4 Type I* 43–50° < 70° Type III** ≤ 42° > 77° * Includes Type IIa, Type IIb, and Type IIc ** Includes Type IIIa and Type IIIb siemens-healthineers.com/maple 9 For the proper use of the software or hardware, please always use At Siemens Healthineers, we pioneer breakthroughs in healthcare. the Operator Manual or Instructions for Use (hereinafter collectively For everyone. Everywhere. By constantly bringing breakthrough “Operator Manual”) issued by Siemens Healthineers. This material is innovations to market, we enable healthcare professionals to deliver to be used as training material only and shall by no means substitute high-quality care, leading to the best possible outcome for patients. the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest Our portfolio, spanning from in-vitro and in-vivo diagnostics version of the software and hardware available at the time of the to image-guided therapy and innovative cancer care, is crucial training. The Operator Manual shall be used as your main reference, for clinical decision-making and treatment pathways. With our in particular for relevant safety information like warnings and strengths in patient twinning, precision therapy, as well as digital, cautions. data, and artificial intelligence (AI), we are well positioned to take on the biggest challenges in healthcare. We will continue to build Note: Some functions shown in this material are optional and might on these strengths to help fight the world’s most threatening not be part of your system. diseases, improving the quality of outcomes, and enabling access to care. Certain products, product related claims or functionalities described in the material (hereinafter collectively “Functionality”) may not We are a team of 66,000 highly dedicated employees across (yet) be commercially available in your country. Due to regulatory more than 70 countries passionately pushing the boundaries requirements, the future availability of said functionalities in of what’s possible in healthcare to help improve people’s lives any specific country is not guaranteed. Please contact your local around the world. 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. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. ACUSON Maple is a trademark of Siemens Medical Solutions USA, Inc. Siemens Healthineers Ultrasound owns the rights to all images. References [1] Kang YR, Koo J. Ultrasonography of the pediatric hip and spine. [3] Graf R. Classification of hip joint dysplasia by means Ultrasonography. 2017;36(3):239-251. doi:10.14366/ of sonography. Arch Orthop Trauma Surg (1978). usg.16051 1984;102(4):248-55. doi:10.1007/bf00436138 [2] Matrawy K, Nouh M. Ultrasound screening for developmental [4] Graf R, Mohajer M, Plattner F. Hip sonography update. dysplasia of the hip and its socioeconomic impact: Experience Quality-management, catastrophes - tips and tricks. of tertiary care health level. Alexandria Journal of Medicine. Med Ultrason. Dec 2013;15(4):299-303. doi:10.11152/ 01/01 2013;50doi:10.1016/j.ajme.2013.04.006 mu.2013.2066.154.rg2 Siemens Healthineers Headquarters Manufacturer Siemens Healthineers AG Siemens Medical Solutions USA, Inc. Siemensstr. 3 Ultrasound 91301 Forchheim, Germany 22010 S.E. 51st Street Phone: +49 9191 18-0 Issaquah, WA 98029, USA siemens-healthineers.com Phone: 1-888-826-9702 siemens-healthineers.com/ultrasound Published by Siemens Medical Solutions USA, Inc. · QR700002310 · 14403 1123 online · ©Siemens Medical Solutions USA, Inc., 2023