Imaging Evaluation of Hemophilia: Musculoskeletal Approach

Keshava, Shyamkumar N.; Gibikote, Sridhar; Doria, A.

doi:10.1055/s-0035-1564798

Cited by 19 publications

(7 citation statements)

References 44 publications

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“…MRI is currently the gold standard for imaging and the compatible additive MRI scale is the principal predefined MRI assessment tool [35]. However, MRI has several disadvantages including lack of feasibility in very young children, access to expensive technology and the time to evaluate each joint [36]. In many countries with limited resources, patients may not undergo MRI because of a lack of availability.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of early musculoskeletal disease in patients with haemophilia

Seuser¹,

Khayat

Négrier³

et al. 2018

Blood Coagulation &Amp; Fibrinolysis

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Early joint damage in patients with haemarthrosis often escapes diagnosis because of insufficient investigation of biomechanical changes. Arthropathy in haemophilia requires complex assessment with several tools. Considering the increased emphasis on an integrated approach to musculoskeletal (MSK) outcomes, re-evaluation of MSK assessment to address individual patient needs is warranted. To advise on the optimal use of current assessment tools and strategies for tailored MSK evaluation in patients with haemophilia. A panel of experts in haemophilic arthropathy evaluated internationally recognized assessment tools through published literature and personal expertise. Each tool was considered, scored and ranked for their utility in the clinical assessment of MSK damage. Subsequently, a patient evaluation table detailing advice on type and frequency of assessments for different patient populations was constructed. To obtain a complete MSK assessment, multiple tools must be used to ensure each criterion is evaluated. For patients with haemophilia, clinical examination of the joint, disease-specific structure/function scores, and activity/participation scores including quality of life are important, and should be performed on a regular basis according to age and clinical condition. Joint imaging is recommended in the prevention, diagnosis and follow-up of haemophilic arthropathy and should be used in conjunction with joint structure and function scores. An integrated approach to MSK assessment using combinations of tools will allow earlier management of dysfunction and may improve long-term outcomes. This approach could be used in long-term follow-up of all patients independent of age and disease stage, especially in children to prevent arthropathy.

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Section: Discussionmentioning

confidence: 99%

Evaluation of early musculoskeletal disease in patients with haemophilia

Seuser¹,

Khayat

Négrier³

et al. 2018

Blood Coagulation &Amp; Fibrinolysis

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show abstract

“…In addition, MR imaging may require sedation in children, is a high-cost modality with long-waiting lists, cannot be used for serial follow-up studies and, in absence of joint effusion, needs intraarticular contrast injection to depict initial osteochondral changes with accuracy [ 17 ]. Although often regarded as the imaging modality of choice for the musculoskeletal system, this technique is not suited to the characteristics of hemophilic arthropathy and cannot be used as a screening method for multijoint assessment and repeated follow-up examinations [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound for Early Detection of Joint Disease in Patients with Hemophilic Arthropathy

Minno

Pasta

Airaldi

et al. 2017

JCM

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Joint bleeding represents the most commonly reported type of hemorrhage in patients affected by hemophilia. Although the widespread use of prophylaxis has been able to significantly reduce the onset of arthropathy, it has been shown that a non-negligible percentage of patients develop degenerative changes in their joints despite this type of treatment. Thus, periodic monitoring of the joint status in hemophilia patients has been recommended to identify early arthropathic changes and prevent the development or progression of hemophilic arthropathy. Ultrasound (US) has proven able to detect and quantify the most relevant biomarkers of disease activity (i.e., joint effusion and synovial hypertrophy) and degenerative damages (i.e., osteo-chondral changes) by means of scoring scales of increasing disease severity. In the present review, we have detailed major literature evidence about the use of US to assess joint status in hemophilia patients, focusing on signs of disease activity and degenerative damages. In particular, we have discussed recent evidence about “point-of-care” use patients with hemophilia.

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“…The HJHS evaluates six joints (bilateral elbows, knees, and ankles) and originally included a global gait analysis; only the knee score was evaluated in the present study. Health-related quality of life was assessed using the SF-36 [19] (range 0-100 points; higher scores indicate higher quality of life) at 1 month, 3 months, 6 months, 12 months, and 24 months of follow-up and MRI findings, which were scored according to the additive International Prophylaxis Study Group (IPSG) MRI score [18] (range 0-17; higher scores indicate more symptoms) at the 24-month follow-up interval. The MRI score includes a soft tissue subscore (scoring of effusion/hemarthrosis, synovial hypertrophy, and hemosiderin deposition) and an osteochondral subscore (scoring of surface erosions, subchondral cysts, and cartilage degradation).…”

Section: Methodsmentioning

confidence: 99%

No Benefit to Platelet-rich Plasma Over Placebo Injections in Terms of Pain or Function in Patients with Hemophilic Knee Arthritis: A Randomized Trial

Duan

et al. 2022

Clin Orthop Relat Res

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Background Hemophilic knee arthritis is one of the most common presenting symptoms of hemophilia, and its management continues to be challenging to practitioners. Preliminary research has suggested that platelet-rich plasma (PRP) may have short-term efficacy in the treatment of hemophilic knee arthritis, but evidence for this treatment is limited. Questions/purposes What is the effectiveness of PRP compared with placebo in (1) reducing pain and improvingThe institution of one or more of the authors (JJG) has received, during the study period,

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Imaging Evaluation of Hemophilia: Musculoskeletal Approach

Cited by 19 publications

References 44 publications

Evaluation of early musculoskeletal disease in patients with haemophilia

Evaluation of early musculoskeletal disease in patients with haemophilia

Ultrasound for Early Detection of Joint Disease in Patients with Hemophilic Arthropathy

No Benefit to Platelet-rich Plasma Over Placebo Injections in Terms of Pain or Function in Patients with Hemophilic Knee Arthritis: A Randomized Trial

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