Reliability of haemophilia early arthropathy detection with ultrasound (HEAD-US) in children: a comparative magnetic resonance imaging (MRI) study

Abstract

Background Ultrasound (US) has been proven to be reliable in the assessment of early haemophilic arthropathy in the adult haemophilic population, however few studies so far focused on the reliability of US specifically in the paediatric haemophilic population. We were interested if the changing appearance of the growing bone hinders the ultrasonographic evaluation of the pathologic processes caused by haemophilic arthropathy. The aim of the study was to assess the reliability of US for evaluation of haemophilic arthropathy in children in comparison to magnetic resonance imaging (MRI). Patients and methods The study included all children aged 6 years or more with severe haemophilia in the country (n = 10). We assessed their elbows, knees, and ankles bilaterally by US and compared the results to the MRI as the reference standard. Pearson correlation coefficient (r) was used to analyse correlation. Results The correlation with MRI for the US for the total score was excellent for all joints (r = 0.849 for the elbows, r = 1 for knees, r = 0.842 for ankles). The correlation of scores for specific joint components showed fair, moderate, or excellent correlation for all joint components in all joints. The correlation was the lowest for the evaluation of cartilage and bone in the ankles (r = 0.546 and r = 0.478) and bone in the elbows (r = 0.499). Conclusions Our study proved that US using the HEAD-US method performed by paediatric radiologists is a reliable tool for detection and quantification of haemophilic arthropathy in children in comparison to MRI.

Orthopedic surgical procedures in people with hemophilia

“…However, without ultrasound (US), the capability to discover subclinical synovitis is greatly diminished, principally in the elbows [10]. Plut et al [11] have demonstrated that US utilizing the HEAD-US (Hemophilia Early Arthropathy Detection with Ultrasound) method is a dependable tool for identification and assessment of hemophilic arthropathy in children in comparison to MRI. Regarding hemophilic pseudotumors, computed tomography (CT) has demonstrated to make the differential diagnosis reliable and to produce helpful knowledge on the magnitude of the lesion and the implication of the skeleton and adjacent organs [12,13].…”

How does joint impairment affect the functional capacity of the lower limb in early haemophilia‐related arthropathy?

“…Hemophilia Early Arthropathy Detection with Ultrasound (HEAD‐US) has been found to have good reliability with Magnetic resonance images to detect early joint damage 7–9 . Recently, using HEAD‐US, it has been reported that PwMH of over 20‐year‐old 90% showed arthropathy in the lower limb 5 .…”

“…Hemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) has been found to have good reliability with Magnetic resonance images to detect early joint damage. [7][8][9] Recently, using HEAD-US, it has been reported that PwMH of over 20-year-old 90% showed arthropathy in the lower limb. 5 Ageing has been determined as an important factor related to the advance of joint impairment independent of the severity of haemophilia.…”