Imaging Modalities for Assessment of Hemophilic Arthropathy

Ultrasound and magnetic resonance imaging of healthy paediatric ankles and knees: a baseline for comparison with haemophilic joints

“…Inclusion of multiple sites for measurements is important at this point of knowledge because while in some pathologic joints, diffuse cartilage loss is seen, in others only focal cartilage abnormalities are noted, which may be lost to US detection if only one or two planes are applied [10,11].With specific regard to haemophilic arthropathy, this multiplanar approach is of particular value since previous studies in haemophilic joints [21,22] reported a centrifugal progression of cartilage damage from the central aspect of the joint to the periphery which makes recognition of early cartilage loss in the central aspect of the joint an important finding in this population. A contradiction to this is the physics-related fact that high-frequency US is unable to penetrate deep tissues to provide information about the integrity of the central aspect of the articular cartilage in large joints, which is not applicable to MRI [8]. In our in vivo study, there were more measurements' sites on MRI than on US due of limitations of US windows to visualize cartilage within the central areas of the joint.…”

“…On the other hand, the advantages of US over MRI in the paediatric population, such as the lack of need for sedation in young children, absence of susceptibility artifacts for haemosiderin deposition which are commonly seen on gradient-echo MRI of haemophilic joints [8], lower cost of examinations and easier access, support the need to improve the US diagnostic accuracy for assessment of maturing joints. This could lead to errors in US and MRI interpretation of minimal joint changes in the paediatric population particularly with regard to loss of cartilage or subchondral changes.…”

“…For US an additional technical limitation is the fact that with high-frequency probes superficial structures are well visualized in contrast to deeper structures which are inaccessible. On the other hand, the advantages of US over MRI in the paediatric population, such as the lack of need for sedation in young children, absence of susceptibility artifacts for haemosiderin deposition which are commonly seen on gradient-echo MRI of haemophilic joints [8], lower cost of examinations and easier access, support the need to improve the US diagnostic accuracy for assessment of maturing joints.…”

Pilot study on 18F‐FDG PET/CT for detection of inflammatory changes in blood‐induced knee arthropathy in a rabbit model

“…The rabbits were assigned to two groups. Group 1 (G1) consisted of five rabbits that each received a unilateral intraarticular blood injection at weeks 1,5,7,9,11,13,15 and 17 for a total of eight injections. Group 2 (G2) consisted of five rabbits that each received only two unilateral intraarticular blood injections at weeks 5 and 17 ( Table 1).…”

“…The imaging modalities that are currently available for assessment of haemophilic arthropathy, conventional radiography, magnetic resonance imaging (MRI) and ultrasound, evaluate structural changes in the joints [7] which typically follow earlier functional and metabolic events. MRI-detected structural joint damage in haemophilic arthropathy is defined as presence of a subchondral cyst, surface erosion or cartilage loss in the joint [8], and indicates failure to treatment which leads to a different pathway in the prophylaxis treatment of haemophilic boys as compared to cases where no MRI-detected structural joint damage is noted.…”