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Vol 3, No 1 (2010)
Review paper
Published online: 2010-03-19

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Hemophilic arthropathy - pathogenesis, clinical symptoms and diagnostic possibilities

Piotr Żbikowski, Michał Matysiak, Paweł Łaguna, Jarosław Ćwikła
Journal of Transfusion Medicine 2010;3(1):19-26.

Abstract

Hemophilic arthropathy is a fundamental clinical problem in patients with severe hemophilia, particularly in patients with inhibitor. Initial intraarticular bleeds occur in first years of life and concern mainly knee, elbow and ankle joints. Overgrowth of synovium and direct toxic effect of blood components on the cartilage are major underlying factors of arthropathy pathogenesis. Typical symptoms include intraarticular bleeds leading to gradual loss of range of motion, joint deformity, muscular atrophia, loss of function and limitation of patient’s activity. Radiological signs of hemophilic arthropathy comprise osteopenia, epiphyseal overgrowth, irregular subchondral layer, erosions and incongruity of articular surfaces, subluxation or/ and angular deformity of the joint. There is growing interest in the use of magnetic resonance imaging and ultrasonography in the diagnosis of early stages of hemophilic arthropathy.

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