Spontaneous recurrent idiopathic knee haemarthrosis in a paediatric patient: successful transcatheter embolization

Selective arterial embolization with gelatin particles for refractory knee hemarthrosis

“…Sizes of particles chosen were 150-250 or 250-350 μm for PA and 500-700 μm for TAGM. Genicular arterial branches and/or the supra-articular popliteal artery were target arteries selectively embolized (4,(7)(8)(9)(10)(11)(12)(13)(14). In all cases reported, embolization was technically successful, with no clinical recurrence except for one.…”

“…Arthroscopic synovectomy is less invasive but may result in the recurrence of hemarthrosis (3). In addition to surgical treatment, in recent years, arterial embolization has been reported to be a less invasive method of treatment (4). After recognizing its effectiveness in our daily clinical work, our institution has employed arterial embolization for refractory knee hemarthrosis despite the use of conservative therapies.…”

“…In addition to surgical methods, case reports in which knee hemarthrosis was successfully treated by transarterial embolization, which is less invasive, have been published as listed in Table 2 (4,(7)(8)(9)(10)(11)(12)(13)(14). All but one of these reports describe treatment for recurrent hemarthrosis after total knee arthroplasty.…”

Hemarthrosis in a Pediatric Patient With Immune Thrombocytopenia and Lyme Arthritis

“…The initial differential was broad and included ITP, thrombotic thrombocytopenic purpura, disseminated intravascular coagulation, hemolytic uremic syndrome, hemophilia, septic or inflammatory arthritis, bursitis, intra-articular venous malformations, or trauma. 7,9,13 Upon reflection, a unifying explanation for the presentation is Lyme disease with resultant inflammatory arthritis and severe thrombocytopenia as causative of the hemarthrosis. The initial symptom improvement was thought to be due to the anti-inflammatory effects of the steroid regimen without treatment of additional underlying disease.…”

“…It is of utmost importance to expedite therapy for hemarthrosis to prevent further joint damage. The initial differential was broad and included ITP, thrombotic thrombocytopenic purpura, disseminated intravascular coagulation, hemolytic uremic syndrome, hemophilia, septic or inflammatory arthritis, bursitis, intra-articular venous malformations, or trauma 7,9,13 . Upon reflection, a unifying explanation for the presentation is Lyme disease with resultant inflammatory arthritis and severe thrombocytopenia as causative of the hemarthrosis.…”