Frequently asked questions

General

Is Librevet Ortho a substitute for surgical training?

No. The app is a planning aid for surgeons and clinicians who already have orthopaedic training. It helps with accurate measurement and visualisation; surgical decisions and execution remain yours.

What image formats can I use?

DICOM, JPEG and PNG. You can import a DICOM directly — the app reads the file itself — drag one straight in, paste it, pick it from the file dialog, or drop a whole study in as a ZIP. Compressed studies are handled as well as uncompressed ones (RLE, JPEG Lossless, JPEG-LS and JPEG 2000).

Higher-resolution images give more precise measurements but use slightly more memory.

How do I get films from my X-ray machine into Librevet?

Three routes, and most practices only ever need the first: let your equipment send studies to your own Librevet address, search a PACS you already run, or install Librevet Edge for older equipment that only speaks classic DICOM. Set any of them up under Settings → Imaging. See Getting radiographs in from your equipment.

Where are my cases stored?

In the cloud, tied to your account. They sync automatically. Radiograph images are stored separately in cloud storage and load on first open of each case in a session.

Does the app work offline?

Partly. A case you already have open keeps working — your edits are written to this device and go up when the connection comes back, and the app tells you which state it is in rather than letting you assume it saved. Look for Offline — saved locally in the top bar.

What needs the network is everything that has to reach the cloud for the first time: signing in, opening a case this device has not seen before, and streaming radiographs that are not yet cached. A case planned offline exists only on that computer until it syncs, so don’t plan offline on a machine you are about to hand back.

Plans and billing

How do I upgrade to Pro?

Click your picture or initials to open the account menu, then Your plan. Choose Pro, monthly or yearly (a year costs the same as eleven months), name your practice, and pay by card. When you come back you are the practice’s owner: every case you already have is in the practice’s shared library, and you can invite colleagues under Your practice straight away. Prices are in US dollars, with tax added where it applies.

Can I get Ultra?

Not yet — Ultra is in development. It is shown on the Your plan page, marked In development, and it cannot be bought.

Who can change our practice’s plan?

The practice’s owner and its managers. They see Your plan in the account menu; other members of the practice do not.

How do I change the card, or get an invoice?

Your plan → Open billing takes you to Stripe’s billing page for your practice. Change the card or the billing address, add a tax number, and download any invoice there.

How do I pay yearly instead of monthly?

On Your plan, pick Yearly, then Pay yearly instead. The change takes effect straight away, and the difference is charged or credited at once.

How do I cancel?

On Your plan, choose Move to Free. Your plan carries on until the end of the period you have paid for, then the practice moves to Free. Until then you can change your mind with Keep. Moving to Free removes nobody from the practice and deletes nothing, but the practice can then only do what Free allows — for example, nobody new can be added.

What happens if a payment fails?

Your plan says so and offers Update card. You keep your plan while the card is retried; if payment still cannot be taken, the practice moves to Free.

Viewing the film

How do I flip an X-ray?

The film’s own toolbar has two flips, side by side. Mirror image, the flip-horizontal icon, reverses the film left to right. Flip image vertically, the flip-vertical icon beside it, turns the film top to bottom. On a narrow pane both sit under ⋯ More image tools instead. A button lights cyan while its flip is on, and clicking it again — it now reads Unmirror image or Unflip image — puts the film back. From the keyboard, H mirrors and V flips; see Keyboard shortcuts.

Mirror a film that has come out back to front, or the wrong way round from the view you are used to reading. Flip one that has come out upside down. A flip, either way, leaves a mirror image of the film, so if a film has simply been turned upside down, turn it back with two quarter-turns of Rotate image instead.

Both flips are display settings on that one view, saved with the case, and both can be undone. The stored image is never altered, and the other views of the same patient are unaffected.

Of the two, only mirroring can change which hip a Norberg angle labels L and which R. Where the app has read a lead side marker on the film, the marker decides, so each label stays with its hip when you mirror. Without a marker, the app assumes the film is hung the usual way for its view, and mirroring tells it the film had been stored back to front — so L and R stay on the same sides of the screen. Flipping top to bottom never changes them, because it leaves the patient’s left on the same side of the picture.

An implant moves with the bone through either flip: it stays on the same stretch of bone, with the same end of the plate at the same end of the bone. Neither flip turns it over, though. A left plate is a physical left part and stays one, so the plate in your surgical report never changes because of how the film is hung. To use the other side’s plate, change the film’s side on the Left/Right chip beside its name. The app reminds you of this the first time you flip a film that has an implant on it.

How do I rotate an X-ray?

Three routes, all to the same rotation:

Rotate image on the film’s toolbar — a dial for any angle, plus −90° and +90° buttons. This is the only route that lands an exact quarter turn or puts a film back to level.
Hold Option/Alt and drag with the left mouse button.
Two-finger twist on a trackpad or touchscreen.

Measurements, implants and overlays are anchored to the bone, not to the screen, so they turn with the film.

The X-ray is too dark or too bright

Open Adjust image on the film’s toolbar — the half-filled circle — for the film’s brightness and contrast. It holds the window presets and the Level and Width sliders, named as every PACS names them: a higher level shows a higher band of greys, so the picture darkens, and a wider window spreads the same 256 shades over more values, so it softens.

While you are working, the quicker way is to drag on the film with the right mouse button, or press W and then drag. Both are re-mappable under Settings → Shortcuts — see Keyboard shortcuts.

Can I see the X-ray as a negative?

Yes. Invert black/white, under ⋯ More image tools on a narrow pane, puts bone dark on a light ground. Click it again for the normal film.

How do I put the view back where it started?

Reset view — the counter-clockwise arrow, first on the film’s toolbar. It re-fits the film to the panel and straightens it, and it is undoable. It deliberately leaves both flips, inversion and your brightness settings alone; those are how you have chosen to read the film, not where you happen to have dragged it.

A number on the film is in the way. Can I move it?

Yes — drag the number itself somewhere clearer, off whatever bone it was covering. The labels on lengths, angles and the TPA all move this way. It stays where you put it through zoom, rotation and flipping, and when the case is opened again, with a dotted line back to what it measures. Double-click it to put it back.

The TPA’s number already sits just past the caudal end of the plateau line, off the joint. To hide every measurement at once instead, use Measurements on the film in the top bar; nothing is deleted.

Calibration

Why does every radiograph need its own calibration?

Radiographic magnification varies between exposures. The same bone projects at slightly different sizes on different shots. Calibrating per-image is what makes the rest of the app’s measurements accurate.

What if there is no marker in the film?

You cannot calibrate a film that has no calibration marker, or other reference of known size, in it, and the app will not let you measure or place a template until a scale is set. That is deliberate: a measurement without calibration is worse than no measurement, because it looks authoritative while being wrong.

Three things count as a marker, so a film without a calibration ball is not necessarily lost:

Any round object whose true diameter you know, taped beside the limb at the same height as the bone — the next question covers what makes a good one. Calibrate with Circle and type its diameter.
A ruler or linear marker. Calibrate with Line over a length you know.
A DICOM’s own pixel spacing, offered as a fourth button when the film carries it. Read Should I trust a DICOM’s own scale? before taking it — it describes the detector, not the bone, and usually reads 10–25% too large.

If the film has none of the three, re-shoot it with a marker in the picture. Nothing in the app can recover the scale from a picture that never carried one.

Can I use a coin or other improvised reference?

Yes, as long as you know its real-world diameter and set that as the reference size before placing. The default is 25 mm (a typical radiopaque sphere), changeable in Settings → Planning Defaults → Your Calibration Markers on each computer you plan from, and still correctable film by film in the calibration sub-panel.

Templates

Are the implants the right size?

Yes, as long as the radiograph is properly calibrated. Template dimensions reflect manufacturer specifications.

What if a template’s dimensions look wrong?

First check the calibration. If that’s correct, report the template via the help icon — it’s almost certainly a library data issue rather than a calibration issue.

Can I add a template that isn’t in the library?

Not directly from the app interface. Template additions are handled administratively. Send a request via the help icon with the manufacturer’s specifications.

How do I change the size of a placed implant?

Click the implant on the film. The swap panel opens in the bottom-left corner of the films with the implant’s sizes, hole counts, side and view. Drag the size slider and the implant on the film changes as you go. See Placing implant templates.

Why is a row in the implant panel greyed out?

The implant on the film has nothing to choose in that row, but other sizes of the same implant do. The row stays so that the size slider and its buttons don’t move while you step through sizes. Step to a size that offers the choice and the row comes back to life. See Placing implant templates.

Yes. Drag it by its header to anywhere over the films, or use the button in its header to put it at the top of the sidebar’s Implants tab instead. The button beside the delete icon there floats it back out. The app remembers your choice on each browser.

How do I delete a placed template?

Select it and press Delete or Backspace, or use the trash icon in the swap panel.

Why does my placed implant rotate when I rotate the X-ray?

By design. Implants are anchored to the bone, not to the screen. Rotating the radiograph for viewing rotates everything attached to it — implants, measurements, overlays — so the implant stays in the correct position relative to the anatomy regardless of viewing angle.

Two routes, and they answer different questions. To send a case to a referring vet or an owner, create a read-only referral link: open the case, click the share icon in the top bar, and copy the link. To work on a case with a colleague, name them on it by email address instead — they sign in and the case appears in their own gallery, and they can edit it. See Sharing and referrals.

How do I stop someone seeing a case?

For a referral link, open the Referrals modal from the share icon and click Revoke. It stops opening straight away, and nobody is notified. For a named colleague, take their email address off the case.

The one thing revoking cannot do is recall a radiograph image the recipient has already loaded — see Sharing and referrals.

Can I put a password on a link?

Yes — it is called a PIN. Tick Require a PIN when you create the link and the app gives you a short code the recipient must type before the case will open. Send it by a different route from the link itself; a PIN in the same email protects nothing.

Only you hold the readable copy, and it is kept on the computer you created it on. If you lose it, revoke the link and make a new one.

Do recipients of a shared link need an account?

No. The link itself grants read-only access. Recipients don’t need to sign up or log in. You can also put a PIN on a link, which they must type before the case opens.

Does the recipient see my later changes?

Yes. A link points at the case, so it always shows the case as it stands. Nothing needs refreshing and no new link is needed. The flip side: a colleague can open the link while you are mid-edit and see a half-finished plan. Their view says so, and shows when the case was last edited.

Can I revoke a shared link?

Yes. From the Referrals modal (top bar), click revoke on any link, and it stops opening straight away. One honest limit: revoking cannot recall a radiograph image the recipient has already loaded — the picture addresses outlive the link. See Sharing and referrals.

Yes. When you create the link, untick Patient and vet identifying details. Species, breed, weight and the rest of the signalment are still shared, because the receiving surgeon needs them. Read your own free-text notes through first — the app can’t strip names out of prose.

Can recipients edit the case?

It depends how you shared it. A referral link is read-only — the recipient sees what you have placed and measured, as it stands, and cannot modify any of it. A named colleague can edit, one person at a time; see the next section.

Reports and record-keeping

Can I get a PDF of the plan?

Yes. Surgical report in the top bar builds a Surgical Plan Report PDF from the case as it stands: the patient details, and then, for each radiograph, its calibration, the measurements you took, the osteotomy planning, and the implants you placed. The button is disabled until the case has at least one radiograph in it.

How do I see who changed what?

Two buttons in the top bar, and they answer different questions:

Audit trail in the top bar: who placed, moved or removed each measurement, and when. It is written by our servers as the change happens, kept for a year, and can be downloaded as a CSV to go into a clinical record.

For the plan as it stood rather than the list of changes, see the next question.

Can I go back to an earlier version of the plan?

Version history, beside the audit trail in the top bar, holds the last 20 saved versions of the plan. Each says who saved it and when, and you can open an earlier one and go back to it.

Appearance

How do I make the screen brighter?

It depends what looks too dark.

The whole page — switch the app to its light theme: Settings → General → Appearance → Theme → Light. Menus, panels and the gallery turn pale, close to a white background. The radiograph stays on a black bed in either theme.
The X-ray itself — open Adjust image on the film’s toolbar, or drag on the film with the right mouse button. More in The X-ray is too dark or too bright.

The monitor’s own brightness is set on your computer, not in the app.

Can I use the app in light mode?

Yes. Settings → General → Appearance → Theme switches between Dark and Light. Dark is the default, and the radiograph itself stays on a black bed in both — an X-ray is dark whichever theme you are in.

The choice is remembered on that computer rather than on your account, so a machine in theatre and a machine in the office can differ.

The text is too small

Settings → General → Appearance → Text size offers Default, Large and Larger. It moves the whole interface — the type, the buttons and the sidebar widen together — so nothing is cut off at the bigger settings.

It does not resize the readouts painted onto the radiograph itself: the millimetre and degree labels on the film are drawn into the picture and are not interface text. If those are what is too small, say so in a bug report and it will be taken as a request.

Performance

Why are templates slow on first session?

The template library prefetches in the background after the app loads. Within a few seconds of opening, all templates are cached and subsequent placements are instant. If you place a template before prefetch completes, the first one may take an extra moment.

Why does the gallery feel sluggish on first open?

Radiograph thumbnails decode on first open. After the first session they’re cached and load instantly. If the gallery is consistently slow, report it via the help icon with your browser and OS.

Collaboration

Can two of us edit the same case at once?

They can both have it open, but only one can edit. The app hands out a single edit lock — “the pen” — so a plan cannot be overwritten by somebody working on it at the same moment:

Whoever opens the case first holds the pen and works normally.
Everyone else opens it read-only and is told who is editing. They can take the pen over whenever they want it.
If the holder closes their laptop or loses connection, the pen lapses by itself after a little over a minute, so a dropped connection never leaves a case stuck.