Hemophilic Arthropathy of Shoulder Joints

Chen, Yeu‐Chin; Cheng, Shin‐Nan; Pan, Ru-Yu; Chang, Shin-Tsu; Li, Tsung-Ying

doi:10.2106/jbjs.k.01646

Cited by 14 publications

(6 citation statements)

References 28 publications

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“…Peripheral nerves seem more vulnerable to stretch in patients with joint hypermobility because of a lack of connective tissue support around the nerves 31 . In addition, it might be hypothesized that increased ROM might shear the glenohumeral articular microvasculature in patients with hemophilia, contributing to the 10 cases of glenohumeral arthropathy seen in such patients while using crutches 32 . As such, more careful attention to crutch fitting may be particularly necessary in crutch users with specific underlying medical conditions that may additionally predispose them to upper limb injury 3 …”

Section: Discussionmentioning

confidence: 99%

“…31 In addition, it might be hypothesized that increased ROM might shear the glenohumeral articular microvasculature in patients with hemophilia, contributing to the 10 cases of glenohumeral arthropathy seen in such patients while using crutches. 32 As such, more careful attention to crutch fitting may be particularly necessary in crutch users with specific underlying medical conditions that may additionally predispose them to upper limb injury. 3 Shorter crutches increased scapular downward rotation and shoulder adduction throughout the gait cycle in this study.…”

Section: Implications For the Scapula And Shouldermentioning

confidence: 99%

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The effect of axillary crutch length on upper limb kinematics during swing‐through gait

Kuntze

Russell

Jivan

et al. 2022

PM&R

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Background: Axillary crutches are commonly used in rehabilitation. Inappropriately fit crutches may result in upper limb pain or injury. Objective: To investigate the effects of axillary crutch length on upper limb kinematics to better understand potential injury mechanisms. It was hypothesized that crutches that were longer or shorter than standard-fit crutches would alter upper limb kinematics. Design: Cross-sectional. Setting: Gait laboratory. Participants: Fifteen healthy males with no prior crutch experience. Interventions: Participants were fit with axillary crutches using standardized methods, as well as with crutches that were 5 cm longer and 5 cm shorter. Participants performed swing-through gait (1.20 AE 0.07 ms À1 ) with all crutch lengths in randomized order. Kinematics were recorded using an optical motion-tracking system and joint angles for the scapula, shoulder, elbow, and wrist were computed. Main Outcome Measures: The effects of crutch length on joint range of motion (ROM) and joint angles at initial crutch contact were analyzed using multivariate analysis (Hotelling's T 2 ; α = .025) and simultaneous confidence intervals (CI). Results: The long-standard crutch fit comparison showed effects across all joints (ROM p = .009; initial contact p < .001). Longer crutches resulted in greater scapular upward rotation (mean difference [95% CI] ROM: 1.0 [À0.2 to 2.2]; initial contact: À2.7 [À4.4, À1.1]) and shoulder abduction (ROM: 0.8 [À0.1 to 1.8]; initial contact: À1.9 [À4.1 to 0.3]). Crutch length also had effects across all joints for the short-standard fit comparison (ROM p = .004; initial contact p = .016). Shorter crutches resulted in greater scapula downward rotation (2.2 [À0.4 to 4.8]) and greater shoulder adduction (2.5 [À0.6 to 5.6]) at initial contact. Shorter crutches also reduced shoulder flexion/extension ROM (À2.5 [À4.4 to À0.6]). Conclusions: Altered crutch length results in scapular and shoulder kinematic deviations that may present risk factors for upper limb injury with crutch-walking. This may underline the importance of appropriate device fitting to reduce injury risk in crutch users.

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Section: Discussionmentioning

confidence: 99%

Section: Implications For the Scapula And Shouldermentioning

confidence: 99%

The effect of axillary crutch length on upper limb kinematics during swing‐through gait

Kuntze

Russell

Jivan

et al. 2022

PM&R

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“…Spontaneous hemarthrosis of the shoulder is rare. Hemophilic arthropathy is a well-known pathology that causes hemarthrosis of the shoulder [6]. Recently, hemarthrosis induced by anticoagulant medication has been reported [7].…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Spontaneous Recurrent Hemarthrosis of the Shoulder with Acromial Erosion Associated with Impingement Syndrome

Fukuta

Miyatake

Matsuura

et al. 2019

Case Reports in Orthopedics

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Spontaneous recurrent hemarthrosis of the shoulder is rare. Most previously reported cases were associated with massive rotator cuff tear and degenerative glenohumeral arthritis. We described two cases of recurrent hemarthrosis without osteoarthritis of the shoulder. Both cases had bony erosion of the acromion, which was confirmed arthroscopically as the origin of bleeding. Arthroscopic coagulation, acromioplasty, and drainage were successful and there was no recurrence of hemorrhage.

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“…1 Repeated joint bleeding results in inflammation-associated damage such as chronic synovitis, cartilage degeneration and bony destruction, which adversely affects patients' quality of life by way of reduced range of motion (ROM), painful joints and muscular atrophy. 2,3 Current techniques used to assess joint condition and monitor progression of haemophilic arthropathy in clinical practice include physical examination, conventional radiography, ultrasonography 4 and magnetic resonance imaging (MRI). 5 Plain x-ray offers inexpensive images of bone and joint space changes but lacks soft tissue details, rendering it suboptimal for evaluating early haemophilic arthropathy.…”

Section: Introductionmentioning

confidence: 99%

¹⁸F‐FDG PET/CT imaging for haemophilic arthropathy compared with clinical, radiological and power Doppler sonographic characteristics of 20 haemophilia patients

Lin

Pan

et al. 2022

Haemophilia

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Introduction and objectives: Repeated joint bleeding in haemophilia patients may lead to haemophilic arthropathy with marked inflammation and synovitis.This study investigated the potential of 18 F-fluorodeoxyglucose positron emission tomography-computed tomography ( 18 F-FDG PET/CT) as a novel diagnostic method for haemophilic arthropathy. Materials and methods:We recruited 20 adult haemophilia patients who reported history of hemarthroses in the shoulder, elbow, hip, knee, or ankle joints. All joints were assessed by power Doppler ultrasonography and radiography, and graded by hyperaemia score and Pettersson score, respectively. Joint pain was evaluated by visual analogue score (VAS). Range of motion (ROM), Haemophilia Joint Health Score (HJHS) and annual joint bleeding rate (AJBR) were recorded. Finally, all participants had whole-body 18 F-FDG PET/CT, and maximum standardized uptake value (SUVmax) of the joints being studied was measured.Results: Thirteen patients had severe haemophilia, and seven had moderate haemophilia. The mean age was 36 years. PET SUVmax showed significant correlations with VAS, ROM, Pettersson score, hyperaemia score, HJHS score and AJBR in all large joints except hip. Joints with pain, hyperaemia and radiographic changes were found to have higher SUVmax than those without these features. Using Youden's index, the optimal cut-off value for early radiographical arthropathy was found to be between 1.9 and 2.0. Conclusion:Our study indicates that 18 F-FDG PET/CT imaging correlated well with various conventional diagnostic techniques. It also demonstrated high sensitivity and specificity for early radiographic arthropathy. 18 F-FDG PET/CT imaging may quantitatively evaluate disease activity of most large joints in a single examination and help detect early haemophilic arthropathy.

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Hemophilic Arthropathy of Shoulder Joints

Cited by 14 publications

References 28 publications

The effect of axillary crutch length on upper limb kinematics during swing‐through gait

The effect of axillary crutch length on upper limb kinematics during swing‐through gait

Two Cases of Spontaneous Recurrent Hemarthrosis of the Shoulder with Acromial Erosion Associated with Impingement Syndrome

¹⁸F‐FDG PET/CT imaging for haemophilic arthropathy compared with clinical, radiological and power Doppler sonographic characteristics of 20 haemophilia patients

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Hemophilic Arthropathy of Shoulder Joints

Cited by 14 publications

References 28 publications

The effect of axillary crutch length on upper limb kinematics during swing‐through gait

The effect of axillary crutch length on upper limb kinematics during swing‐through gait

Two Cases of Spontaneous Recurrent Hemarthrosis of the Shoulder with Acromial Erosion Associated with Impingement Syndrome

18F‐FDG PET/CT imaging for haemophilic arthropathy compared with clinical, radiological and power Doppler sonographic characteristics of 20 haemophilia patients

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¹⁸F‐FDG PET/CT imaging for haemophilic arthropathy compared with clinical, radiological and power Doppler sonographic characteristics of 20 haemophilia patients