The Correlation Between the <scp>HEAD‐US‐C</scp> Score and <scp>HJHS</scp> in Hemophilic Arthropathy of the Knee

Fang, Yunmei; Guo, Yulin; Qin, Ting; Luan, Yuting; Cui-ming, Zhang

doi:10.1002/jum.16072

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…The HEAD-US-C scale was demonstrated to be a reliable and comprehensive US scale for hemophiliacs in our previous study. 13 The present study analyzed the accuracy of US in the diagnosis of knee joints in patients with SHA compared with that of MRI and validated the usefulness of the HEAD-US-C scale in the assessment of hemophilic arthropathy.…”

Section: Discussionmentioning

confidence: 74%

“…Therefore, the inclusion of joint effusion and synovial vascular hyperplasia in the HEAD-US-C scale is of great value, especially in patient cases with acute and painful joint swelling. 13 There is considerable controversy regarding the demonstration of hemosiderin deposition by US. Soliman et al 17 showed that US evaluation of hemosiderin deposition is complicated.…”

Section: Discussionmentioning

confidence: 99%

“…Distinguishing the cause of pain can thus help patients decide whether they should undergo factor replacement therapy. Therefore, the inclusion of joint effusion and synovial vascular hyperplasia in the HEAD‐US‐C scale is of great value, especially in patient cases with acute and painful joint swelling 13 …”

Section: Discussionmentioning

confidence: 99%

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Diagnostic Value of the HEAD‐US‐C Scale for the Knees of Severe Hemophilia A Patients

Fang,

Sun,

Chang

et al. 2023

J of Ultrasound Medicine

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ObjectivesThis study aimed to assess the reliability of the Hemophilia Early Arthropathy Detection with Ultrasound in China (HEAD‐US‐C) scale for the knees of severe hemophilia A (SHA) patients and to determine its diagnostic accuracy for assessments of knee‐joint lesions in comparison with magnetic resonance imaging (MRI).MethodsWe collected data from 32 knee joints of 21 patients diagnosed with SHA. The knees were evaluated based on the HEAD‐US‐C scale and the results were compared with the International Prevention Study Group (IPSG) scale. The HEAD‐US‐C scale was applied independently by two trained ultrasonographers blinded to the MRI results. The IPSG scale was applied independently by two radiologists blinded to the clinical data and ultrasound (US) results.ResultsThe IPSG and HEAD‐US‐C scales exhibited good to excellent inter‐rater reliability. Additionally, there was good to excellent agreement between the US and MRI results for the detection of knee lesions in SHA patients. The sensitivities of US for joint effusion, synovial hyperplasia, cartilage loss, and bone‐surface irregularities in the knees of patients were 92.59, 100, 95.45, and 87.50%, respectively. The HEAD‐US‐C scale was positively correlated with the IPSG scale.ConclusionsUS is important for evaluating knee lesions in patients with SHA and may potentially replace MRI.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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Diagnostic Value of the HEAD‐US‐C Scale for the Knees of Severe Hemophilia A Patients

Fang,

Sun,

Chang

et al. 2023

J of Ultrasound Medicine

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“…All patients in our study had severe hemophilia and included both young adults and children. Many studies have been conducted to investigate the relationship between the HJHS and the HEAD-US scores in hemophilia patients (12)(13)(14)(15)(16). The researchers have found a moderate correlation between the HJHS score and the osteochondral component of the US score (r=0.45), but a poor correlation between the HJHS score and the soft tissue component of the US score (r=0.26) in a study of 51 children with severe hemophilia/von Willebrand disease (12).…”

Section: Discussionmentioning

confidence: 99%

Assessment of Haemophilic Arthropathy in Patients With Severe Hemophilia Using the Hemophilia Early Arthropathy Detection With Ultrasound (Head-Us) Score and the Hemophilia Joint Health Score (Hjhs) by Different Caregivers

Yılmaz Orulluoğlu,

Kaya,

Satış

et al. 2024

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

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Objective: There are few studies on the assessment of hemophilic arthropathy using the hemophilia early arthropathy detection with ultrasound (HEAD-US) and hemophilia joint health score (HJHS) scores.This study aimed to examine how radiologists and rheumatologists could evaluate hemophilic arthropathy in individuals with severe hemophilia using HEAD- US and HJHS scores simultaneously. Material and Methods: Between 2021 and 2022, 168 joints from 28 individuals with severe hemophilia A and B were investigated at six-month intervals (TP1 and TP2). The HJHS scores of all patients were recorded. The HEAD-US in each hemophilic patient's six joints (elbow, knee, and ankle) were evaluated by radiologists and rheumatologists. Results: The ankle assessment by HEAD-US showed the highest rate (34%) of synovitis by radiologist evaluation at TP1 in patients with an HJHS score of 0. The knee assessment by HEAD-US showed the highest rate (56%) of synovitis and bone damage by rheumatologist evaluation at TP1 in patients with an HJHS score of 0. HEAD-US ankle and knee examinations revealed the highest rate of synovitis (34%) by radiologist evaluation at TP2 in patients with an HJHS score of 0. The HEAD-US knee assessment revealed the highest rate of synovitis (44%) by rheumatologist evaluation at TP2 in patients with an HJHS score of 0. In the assessment of elbow and knee joints, there was a moderate to good correlation between HJHS and HEAD-US scores by different caregivers at different time points (p< 0.05). Conclusion: Our findings indicate that clinicians play a crucial role in the early diagnosis of subclinical hemophilic arthropathy, with HEAD-US scoring conducted by rheumatologists similar to radiologists in severe hemophilia patients without pathology in HJHS scoring.

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“…Joint status can be evaluated clinically and by ultrasound. The Hemophilia Early Arthropathy Detection with Ultrasound in China (HEAD-US-C) is based on HEAD-US and adds two activity indicators of joint effusion and synovial vascular hyperplasia, which is highly sensitive to subclinical bleeding ( 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical analysis and quality of life survey of hemophilia B patients in the central and western regions of China

Wang,

Xu,

et al. 2024

Front. Pediatr.

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ObjectiveTo study the current status of hemophilia B (HB) patients in the central and western regions of China.MethodsThis cross-sectional, multicenter study was conducted in seven provinces in the central and western regions of China from April 2019 to June 2023. Samples were collected for the factor IX activity, inhibitor screen, and gene mutation. Furthermore, the status of six index joints and quality of life (QoL) were assessed.ResultsA total of 185 HB patients (mild 15, moderate 75, and severe 95) with a median age of 12.17 years were enrolled. 30.3% (56/185) of patients had a family history of HB. 34.6% (64/185) of HB patients had diagnostic delay and 38.5% (69/179) experienced treatment delay. The incidence of inhibitors was 6.1% (11/179). We identified 123 genetic variants in this study, with missense mutations being the most common. 84.0% (89/106) of HB mothers were genetically identified as carriers, with 27.7% (13/47) of carriers having clotting factor levels less than 0.40 IU/ml. 71.4% (132/185) of HB patients had a history of joint hemorrhage, with a rate of target joint in these patients was 64.4% (85/132). Lower extremity joints were most often affected in patients. The Hemophilia Joint Health Score (HJHS) score was significantly positively correlated with the Hemophilia Early Arthropathy Detection with Ultrasound in China (HEAD-US-C) (r = 0.542, P < 0.001). Patients who received prevention treatment, inhibitor negative, without treatment delay, and without high-intensity replacement therapy showed a higher total score of the short form-36 health survey (SF-36).ConclusionsOne-third of HB patients had delay in diagnosis and treatment, and the incidence of inhibitors was 6.1%. Target joints were present in nearly half of HB patients. Missense was the main mutation type. 84.0% of mothers of HB patients in this study were found to be carriers. HEAD-US-C and HJHS can complement each other in the evaluation of joint status and give a valid basis for early clinical management. Early detection and preventive treatment, as well as reducing high-intensity replacement therapy and inhibitor generation, can effectively improve the QoL of patients.

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The Correlation Between the HEAD‐US‐C Score and HJHS in Hemophilic Arthropathy of the Knee

Cited by 5 publications

References 23 publications

Diagnostic Value of the HEAD‐US‐C Scale for the Knees of Severe Hemophilia A Patients

Diagnostic Value of the HEAD‐US‐C Scale for the Knees of Severe Hemophilia A Patients

Assessment of Haemophilic Arthropathy in Patients With Severe Hemophilia Using the Hemophilia Early Arthropathy Detection With Ultrasound (Head-Us) Score and the Hemophilia Joint Health Score (Hjhs) by Different Caregivers

Clinical analysis and quality of life survey of hemophilia B patients in the central and western regions of China

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