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HEPHAESTUS project
Introduction
This guide is designed to walk you through all the features of the platform, from basic navigation to the use of advanced search tools. The goal of HEPHAESTUS is to provide physicians, researchers, and medical trainees with a comprehensive and standardised resource to learn how to identify and classify joint damage in patients with haemophilia using standard ultrasound assessment criteria.1. First steps: exploring the Atlas
1.1 Homepage
From here you can access the main sections of the atlas. The “Explore the Atlas” section shows the three primary target joints:
- Knee
- Elbow
- Ankle
To begin, click one of the joints to access the next level of the atlas.
2. Learning pathway: from technique to clinical case
HEPHAESTUS is structured to follow a logical learning pathway.
2.1 Stage 1: Choose a projection
After selecting a joint (e.g., Knee), the next page will present the available projections. Click a projection (e.g., Anterior) from the sidebar or the main page to proceed.
2.2 Stage 2: Technical sheet
The projection page contains rich instructional content:
- How to perform the examination: a detailed guide on patient positioning and ultrasound probe placement.
- Video Tutorial: a practical video demonstrating the examination (optional, if available).
- Anatomical Zones: collapsible sections that describe in detail each anatomical structure visible in that projection, with reference images and descriptions of normal and pathological findings.
2.3 Stage 3: Explore clinical cases
At the bottom of the projection page, you will find the “Clinical Cases by Severity Grade – Standard Classification” section. Here you can access real clinical cases organised by severity level.
• Click one of the coloured buttons (Normal, Mild, Moderate, Severe) to view a list of cases corresponding to that level of damage.
2.4 Stage 4: Analyse a clinical case
After selecting a severity level, you will be taken to a results page. Click “VIEW DETAILS” on a case to open it.
The clinical case page is the core of the atlas and includes:
| Section | Description |
|---|---|
| Ultrasound Images | The original ultrasound image and its annotated version, presented side by side for immediate comparison. |
| Classification | Case metadata, including the unique code and severity classification. |
| Patient Data | Demographic and functional information (age, sex, ROM). |
| History & Physical Examination | Comprehensive history and physical examination linking the image to the clinical picture. |
| Ultrasound Findings | A structured summary of ultrasound findings. |
| Anatomical Zones | An in-depth analysis of each structure, including quantitative measurements and detailed descriptions of findings. |
| Direct Comparison | A section encouraging you to compare the current case with others of different severity. |
3. Advanced features
3.1 Advanced Search
Accessible from the sidebar, the “Advanced Search” page allows you to find specific cases using a combination of filters:
- Joint, View, Severity: to narrow down to a specific anatomical combination.
- Search (free text): to search for keywords within case descriptions (e.g., “synovitis”, “erosion”).
- Age, Sex: to filter cases by demographic data.
You can also switch the results view from Grid to Table for a more structured analysis.
3.2 Atlas Statistics
The “Statistics” page, accessible from the footer, provides a dashboard offering an overview of all content in the atlas. It is useful for understanding the distribution of cases, patient demographics, and the project’s progress status.
4. Clinical Case Comparison
4.1 Accessing the comparison
There are two ways to access the comparison feature:
Method 1: From the clinical case page
- Scroll to the “Direct Comparison” section at the bottom of the page.
- You will find: a prompt to compare the current case with others of different severity; an indication of the number of cases available (e.g., “Cases available for comparison: 3 of 3 possible”); and a button or link to access the comparison page.
Method 2: From the dedicated comparison page
You can access the comparison page directly by navigating to the “Compare” section from the main menu or the sidebar.
4.2 How the comparison works
- Select the Joint and Projection: choose the combination you wish to analyse (e.g., Knee – Anterior View).
- View cases side by side: cases are presented in a grid or table, organised by severity level (Normal, Mild, Moderate, Severe).
- Compare images: view ultrasound images side by side to identify progressive differences in joint damage.
- Analyse clinical data: in addition to images, compare descriptive ultrasound findings, quantitative measurements (e.g., synovial thickness, erosion size), and patient data (age, ROM, symptoms).
4.3 Educational value of the comparison
- Visualises progression: shows how arthropathy evolves from normal to severe, helping you recognise early signs.
- Standardises classification: by comparing cases already classified according to standardised criteria, you learn to assess severity consistently.
- Improves visual memory: side-by-side comparison reinforces learning and recognition.
- Supports clinical decision-making: understanding disease stages aids in planning treatment and appropriate follow-up.
4.4 Tips for an effective comparison
- Start from the normal: always begin with a normal case as a reference for a healthy joint.
- Proceed gradually: analyse cases in ascending order of severity (Normal → Mild → Moderate → Severe) to capture incremental changes.
- Focus on a single structure: concentrate on a specific anatomical area (e.g., quadriceps tendon) and observe how it changes across severity levels.
- Take notes: record key differences you observe between levels to consolidate learning.