Point‐of‐care ultrasound in haemophilic arthropathy: will the <scp>HEAD</scp>‐<scp>US</scp> system supplement or replace physical examination?

Martinoli, Carlo; Minno, Matteo Nicola Dario Di; Pasta, Gianluigi; Tagliafico, Alberto

doi:10.1111/hae.12840

Cited by 23 publications

(35 citation statements)

References 8 publications

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“…Scoring is based on pattern recognition analysis avoiding measurements and the interpretation of findings has been standardized to reduce interoperator variability [ 56 ]. The joint assessment based on the HEAD-US system can be accomplished with portable US machines without any need for high-end or proprietary technology and can be learned by non-imaging specialists after a short period of training [ 57 ]. It has been proposed that, in daily practice, the HEAD-US system would find its place as a supplement to physical examination assessment tools, such as the Hemophilia Joint Health Score (HJHS), in order to provide more objective assessment of findings and increased sensitivity in detecting joint abnormalities [ 57 ].…”

Section: “Point-of-care” Us and The Head-us Architecturementioning

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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Section: “Point-of-care” Us and The Head-us Architecturementioning

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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“…The recent remarkable technical development in image processing of US has established a significant role for US in musculoskeletal imaging including haemophilic arthropathy. Due to its wide availability and low operating cost, US has attracted the interest of clinicians for point‐of‐care (POC) assessment of joints of haemophilic patients in their clinics . Full (diagnostic) joint US refers to the use of US in radiology departments to diagnose and follow pathologic findings throughout the extent of the joint that is amenable to visualization by conventional US transducers (typical frequency range: 3.5–15 MHz) considering a 360 ° coverage approach.…”

Section: Introductionmentioning

confidence: 99%

Imaging of haemophilic arthropathy in growing joints: pitfalls in ultrasound and MRI

et al. 2017

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The purpose of this review was to summarize the current knowledge on the utilization of magnetic resonance imaging (MRI) and ultrasound (US) for assessing arthropathy in children and adolescents with haemophilia and to recognize the limitations of each imaging modality and pitfalls in the diagnosis of soft tissue and osteochondral abnormalities. Awareness of MRI and US limitations and pitfalls in the assessment of joints in persons with haemophilia is essential for accurate diagnosis and optimal management of haemophilic arthropathy.

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“…5 In recent years, the musculoskeletal ultrasound (MSKUS) has been applied in the evaluation of both soft tissue and osteochondral changes of HA and was recommended by the World Federation of Haemophilia (WFH) for its advantages, such as convenience, time-effectiveness, high resolution of soft tissue and blood flow detection. [7][8][9] The definitive investigation into the age-related severity and distribution of HA using the HEAD-US scoring system has not been reported in developing countries yet. The validity and reliability of this system in evaluating HA have been previously confirmed.…”

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confidence: 99%

“…The validity and reliability of this system in evaluating HA have been previously confirmed. [7][8][9] The definitive investigation into the age-related severity and distribution of HA using the HEAD-US scoring system has not been reported in developing countries yet. Herein, we present the severity and distribution of HA by analysing the knee, ankle and elbow arthropathies in Chinese patients with haemophilia.…”

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confidence: 99%

Age‐related severity and distribution of haemophilic arthropathy of the knee, ankle and elbow among Chinese patients with haemophilia

et al. 2019

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Introduction and aims Age‐related severity and distribution of haemophilic arthropathy (HA) among Chinese patients with haemophilia using the Haemophilia Early Detection with Ultrasound (HEAD‐US) system have not been extensively studied. Methods In our study, 89 patients with moderate and severe haemophilia were recruited. A total of 534 joints (knees, ankles and elbows on both sides included) were evaluated using musculoskeletal ultrasound (MSKUS) and scored using the HEAD‐US system. Results Prevalence and average number of HA were 39.1% and 0.7, 90.6% and 3.2, 94.1% and 4.5, and 100% and 4.3 for ages ≤10, 11‐20, 21‐30 and 31‐40 years, respectively. Prevalence and mean number of knee, ankle and elbow arthropathies also increased with age, although joint damages progressed in unparallel patterns. A significant difference in synovium subscores was observed between patients aged <10 and >10 years. An increasing tendency was observed in cartilage and subchondral bone subscores along with age before 30 years. No significant difference in mean joint scores was found between patients receiving on‐demand therapy and those receiving on‐demand to low‐dose prophylactic therapy. Conclusions Haemophilic arthropathy developed in early childhood and progressed mainly before 30 years of age among Chinese patients with haemophilia, although in different ways among the knee, ankle and elbow.

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Point‐of‐care ultrasound in haemophilic arthropathy: will the HEAD‐US system supplement or replace physical examination?

Cited by 23 publications

References 8 publications

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

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

Imaging of haemophilic arthropathy in growing joints: pitfalls in ultrasound and MRI

Age‐related severity and distribution of haemophilic arthropathy of the knee, ankle and elbow among Chinese patients with haemophilia

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