Correlation between clinical, radiological and ultrasonographical image of knee joints in children with haemophilia

Abstract

The aims of the study were to evaluate the clinical, radiological and ultrasonographical images of knee joints in children with severe haemophilia and von Willebrand's disease, to determine the correlation between these images and to assess the usefulness of ultrasonography (USG) in evaluating the intensity of haemophilic arthropathy. Thirty-nine boys were included in the study, all of them with a past history of knee bleeds. The average age of the children was 10.02 +/- 3.01 years. In patients with slight (1-3 points) and moderate (4-7 points) radiological changes in knee joint bones, an increase in synovial fluid, considerable hypertrophy and inflammation of the synovium were observed in USG. In haemophilic patients with severe (8-13 points) bone changes, the amount of fluid was usually normal and there was slight inflammation but considerable hypertrophy of the synovium. Radiological evaluation of haemophilic arthropathy was made according to the Pettersson classification. A good correlation between the degree of cartilage damage in USG and the progression of bone changes in radiographs was found. Cartilage and bone damage progressed with the increase in the number of intra-articular haemorrhages into the knee joint. In our opinion USG is useful in evaluating the fluid, synovium and cartilage of joints in haemophiliacs.

Orthopedic disorders of the knee in hemophilia: A current concept review

“…Ultrasonography (US) can be used to demonstrate hypertrophy of the synovium and the presence of fluid [13,14] . However, validation of US for the assessment of HA has not been established yet [15][16][17] . Magnetic resonance imaging is the gold standard for the diagnosis of synovitis.…”

Imaging Modalities for Assessment of Hemophilic Arthropathy

“…MRI is useful for both clinical and research purposes. However, few ultrasound scales have been devised for the evaluation of hemophilic joints [31,34,[39][40][41]. Before performing synovectomy in therapy-resistant target joints, MRI can confirm the presence of synovial hypertrophy and reveal alternative explanations for the numerous bleeds even if ultrasonography in some cases can give more exact information on the amount and activity of the synovial hypertrophy.…”

Outcome measures monitoring physical function in children with haemophilia: a systematic review

“…Klukowska et al [24] Schoenmakers et al [18] Soucie et al [25] Douma-van Reit et al [15] Garcia et al [26] Koiter et al [21] Bernal-Lagunas et al [27] Soucie et al [28] Goniometer Axis of goniometer placed over joint axis and arms of goniometer placed along limb segments proximal and distal to joint. Arc of maximum joint movement recorded 0-360M aximal aerobic capacity Falk et al [17] Van der Net et al [29] Engelbert et al [20] Douma-van Riet et al [15] Groen et al [31] Maximal aerobic test on cycle ergometer or treadmill.…”