A new and simplified comprehensive ultrasound protocol of haemophilic joints: the Universal Simplified Ultrasound (US-US) protocol

Kandagaddala, Madhavi; Sundaramoorthy, M.; Keshava, Shyamkumar N.; Gibikote, Sridhar; Mahata, Koyeli Mary; Kavitha, M.; Poonnoose, Pradeep Mathew; Srivastava, Alok

doi:10.1016/j.crad.2019.07.018

Cited by 11 publications

(27 citation statements)

References 17 publications

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“…26 Tailored educational strategies (Appendix S2) may be required to improve the utilization across different specialties for those interested in skill development or who obtain a medical directive to perform POCUS as part of their scope of practice. 10,[27][28][29][30][31] The utility of POCUS to assess an acute bleed versus no bleed is significant and the most salient perceived clinical application identified by this survey. Other perceived areas of use for POCUS may help inform where to focus the interest and effort for further education.…”

Section: Discussionmentioning

confidence: 99%

“…Respondents from those 24 countries stated that overall 26% of physiotherapists are using POCUS with the proportion usage as high as 67% in the UK and 50% in France 26 . Tailored educational strategies (Appendix ) may be required to improve the utilization across different specialties for those interested in skill development or who obtain a medical directive to perform POCUS as part of their scope of practice 10,27‐31 …”

Section: Discussionmentioning

confidence: 99%

“…8 Ultrasound may include power Doppler, colour Doppler or contrast-enhanced techniques to determine the extent of micro-and macrovascular abnormalities and inflammation. [9][10][11] The explosion of novel haemostatic agents, both clotting factor based and not, as well as gene therapy for haemophilia A and B has mandated an urgent need to further define the imaging assessment of joints/muscles in PWH including the relative roles and value of different imaging modalities, such as plain radiographs, MRI and especially ultrasound for the assessment and management of MSK disease. 12,13 In 2017/2018, the members of the Ultrasound Taskforce of the Imaging Expert Working Group of the International Prophylaxis…”

Section: Introductionmentioning

confidence: 99%

“…Point‐of‐care ultrasound (POCUS) is commonly conducted by non‐radiologists/ultrasonographers in out‐patient clinics to answer specific diagnostic questions in contrast to full diagnostic ultrasound, a modality predominantly performed and/or interpreted by certified ultrasonographers and radiologists 8 . Ultrasound may include power Doppler, colour Doppler or contrast‐enhanced techniques to determine the extent of micro‐ and macrovascular abnormalities and inflammation 9‐11 …”

Section: Introductionmentioning

confidence: 99%

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Use of ultrasound for assessment of musculoskeletal disease in persons with haemophilia: Results of an International Prophylaxis Study Group global survey

et al. 2020

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Aim: The objective of this survey was to understand the global trends of imaging assessments in persons with haemophilia, focusing on point-of-care ultrasound (POCUS). Insights into the barriers impeding its widespread proliferation as a frontline imaging modality were obtained. Methods: The survey opened in September of 2017 and closed in May of 2018. Haemophilia Treatment Centres (HTCs) treating both paediatric/adult patients were the population of interest. A REDCap survey of 25 questions was disseminated to 232 clinical staff in 26 countries. Results: The majority of respondents (88.3%, 91/103) reported that POCUS is most useful to confirm or rule out a presumed acute joint bleed. European HTCs reported the highest routine use of POCUS at 59.5% (22/37) followed by HTCs in the "Other" countries of the world at 46.7% (7/15) and North American HTCs at 43.9% (25/57). At the time of the survey, physiotherapists were identified as the clinical staff who perform POCUS 52.8% (28/53) of the time, in contrast with nurses/nurse practitioners who represent only 5.7% (3/53) of users. The greatest perceived barriers to the implementation of POCUS are the lack of trained healthcare professionals who

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of ultrasound for assessment of musculoskeletal disease in persons with haemophilia: Results of an International Prophylaxis Study Group global survey

et al. 2020

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“… 14 , 15 , 16 , 17 , 18 Several point‐of‐care musculoskeletal ultrasound (POC‐MSKUS) and full diagnostic MSKUS scanning protocols and scoring systems have been proposed over the past two decades, with varying degrees of validation, adoption, and implementation by HTCs. 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 Ideally, one key goal for MSKUS would be to detect clinically significant joint disease or predictors of joint disease at an early stage where intervention (e.g., administration or intensification of prophylaxis) is likely to be beneficial. 4 , 27 …”

Section: Introductionmentioning

confidence: 99%

Musculoskeletal ultrasound in hemophilia: Results and recommendations from a global survey and consensus meeting

Bakeer

Dover

Babyn

et al. 2021

Research and Practice in Thrombosis and Haemostasis

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Introduction For persons with hemophilia, optimization of joint outcomes is an important unmet need. The aim of this initiative was to determine use of ultrasound in evaluating arthropathy in persons with hemophilia, and to move toward consensus among hemophilia care providers regarding the preferred ultrasound protocols for global adaptation. Methods A global survey of hemophilia treatment centers was conducted that focused on understanding how and why ultrasound was being used and endeavored to move toward consensus definitions of both point‐of‐care musculoskeletal ultrasound (POC‐MSKUS) and full diagnostic ultrasound, terminology to describe structures being assessed by ultrasound, and how these assessments should be interpreted. Next, an in‐person meeting of an international group of hemophilia health care professionals and patient representatives was held, with the objective of achieving consensus regarding the acquisition and interpretation of POC‐MSKUS and full diagnostic ultrasound for use in the assessment of musculoskeletal (MSK) pathologies in persons with hemophilia. Results The recommendations were that clear definitions of the types of ultrasound examinations should be adopted and that a standardized ultrasound scoring/measurement system should be developed, tested, and implemented. The scoring/measurement system should be tiered to allow for a range of complexity yet maintain the ability for comparison across levels. Conclusion Ultrasound is an evolving technology increasingly used for the assessment of MSK outcomes in persons with hemophilia. As adoption increases globally for clinical care and research, it will become increasingly important to establish clear guidelines for image acquisition, interpretation, and reporting to ensure accuracy, consistency, and comparability across groups.

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

Tamsel

Kavaklı

Özbek

et al. 2022

J of Clinical Ultrasound

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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.

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A new and simplified comprehensive ultrasound protocol of haemophilic joints: the Universal Simplified Ultrasound (US-US) protocol

Cited by 11 publications

References 17 publications

Use of ultrasound for assessment of musculoskeletal disease in persons with haemophilia: Results of an International Prophylaxis Study Group global survey

Use of ultrasound for assessment of musculoskeletal disease in persons with haemophilia: Results of an International Prophylaxis Study Group global survey

Musculoskeletal ultrasound in hemophilia: Results and recommendations from a global survey and consensus meeting

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

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