The value of ultrasonography in detecting early arthropathic changes and contribution to the clinical approach in patients of hemophilia

J Clin Ultrasound. 2022 Mar;50(3):428-432. doi: 10.1002/jcu.23164. Epub 2022 Mar 2.

Abstract

PURPOSE\AIM: Hemophilia affects the blood clotting process, is a genetic disease characterized by recurrent bleeding. The hemophilia early arthropathy detection with ultrasound (HEAD-US) procedure and scoring method were designed for the detection of early changes in affected joints of patients. In this article, it was aimed to detect early arthropathic changes in the joints of hemophilia patients with the HEAD US scoring system and to investigate its clinical contribution. It was aimed to investigate the effectiveness of HEAD-US scoring in showing early joint damage in subclinical hemophilia cases and its contribution to treatment.

Methods: The present study included 50 hemophilia patients who were admitted to Departments of Pediatric and Adult Hematology for routine follow-up. During routine follow-up controls, patients were scored by physical examination and HJHS 2.1 and by ultrasonography and HEAD US. Statistical tests were used to analyze joint health status and the results of US examination in the patient group.

Results: A total of 294 joints (elbow n = 100, knee n = 94, ankle n = 100) were evaluated by ultrasonography. The mean HJHS and HEAD-US scores of the patients were 14.94 ± 15.18 and 15.6 ± 12.6, respectively.

Conclusions: HEAD-US is accepted to be more sensitive than HJHS in detecting early signs of arthropathy. Detection of early abnormalities by ultrasonography will enable the development of individualized treatment protocols and to the prevention of arthropathy development.

Keywords: HEAD-US; hemophilia; ultrasound.

MeSH terms

  • Adult
  • Arthritis*
  • Child
  • Hemophilia A* / complications
  • Hemophilia A* / diagnosis
  • Hemophilia A* / therapy
  • Hemorrhage
  • Humans
  • Joint Diseases* / diagnostic imaging
  • Ultrasonography / methods