Hemarthrosis

Source: Wikipedia, the free encyclopedia.
Hemarthrosis
Other namesHaemarthrosis
Joint pain, swelling, and redness

Hemarthrosis is a

hemophilia
.

Causes

It usually follows

hemophilia.[citation needed
]

It can be associated with

It has also been reported as a part of hemorrhagic syndrome in the Crimean-Congo Hemorrhagic Fever, suggesting a viral cause to the bleeding in a joint space.[2][3]

Diagnosis

Synovial fluid examination[4][5]
Type WBC (per mm3) % neutrophils Viscosity Appearance
Normal <200 0 High Transparent
Osteoarthritis <5000 <25 High Clear yellow
Trauma <10,000 <50 Variable Bloody
Inflammatory 2,000–50,000 50–80 Low Cloudy yellow
Septic arthritis >50,000 >75 Low Cloudy yellow
Gonorrhea ~10,000 60 Low Cloudy yellow
Tuberculosis ~20,000 70 Low Cloudy yellow
Inflammatory: Arthritis, gout, rheumatoid arthritis, rheumatic fever

Hemarthrosis is diagnosed through the methods listed below:

A physical examination is the first step, with the joints of the patient moved and bent to study possible loss of functioning.

Synovial fluid analysis is another method to diagnose Hemarthrosis. It involves a small needle being inserted into the joint to draw the fluid.[6] Reddish-colored hue of the sample is an indication of the blood being present. Imaging tests are normally done. The tests also include MRI, ultrasound and X-ray test, which give better information about the joint inflammation.[7] Although MRI is superior method for this assessment, the US using the HEAD-US method performed by paediatric radiologists is a reliable tool for detection and quantification of haemophilic arthropathy in children in comparison to MRI.[8]

Treatment

In hemophilia it may occur spontaneously, and recurrent hemarthroses are a major cause of

hemophilic arthropathy, requiring synovectomy, joint replacement[9]
and increased medical therapy to prevent further bleeding episodes.

Reducing hemarthroses events using intravenous administration of blood clotting factor concentrate on a regular basis starting in early childhood, reduces joint deterioration and increases the person's quality of life compared to "on demand" treatment (treating after a bleed).[10] The minimal effective dose and best dosage frequency have not been established.[10] It is not clear, due to lack of sufficient data, if preventative therapy with clotting factor concentrate is also effective at reducing joint deterioration if treatment is started after joint damage has occurred.[10]

Complications

Up to a quarter of all severe ligament or capsular knee injuries leading to a hemarthrosis are associated with

cartilage damage that can lead to progressive degenerative arthritis.[11]

  • X-ray of Hemarthrosis
    X-ray of Hemarthrosis
  • X-ray of Hemarthrosis
    X-ray of Hemarthrosis

References

External links