Hemophilic arthropathy is a degeneration of a joint caused by recurrent bleeding into a joint due to haemophilia, an inherited blood disorder. It is the most common complication of hemophilia - it occurs in about 70-80 percent. cases. What are the causes and symptom of hemophilic arthropathy? What is the treatment? How to prevent it?

Hemophilic arthropathyis a degeneration of a joint resulting from recurrent bleeding into a joint due to hemophilia. Repeated bleeding into the joint causes irreversible damage and deformation, combined with atrophy of adjacent muscle groups and limited mobility. Intra-articular bleeding is the most common complication of hemophilia - it occurs in about 70-80 percent. cases.

Hemophilic arthropathy - causes

The purse of the joint is lined with a synovium (synovium) in which there are many small blood vessels. Bleeding occurs spontaneously as a result of damage to the vessels in the synovium - with or without an injury. After bleeding in the synovium of the joint, inflammation may persist. Inflamed pulpwood bleeds easily again, which means that another hemorrhage occurs before the first bleeding has been completely absorbed. Repeated bleeding into the joints weakens the synovium. It stops producing the fluid that allows the joint to move smoothly. Subsequently, the cartilage and articular surface are damaged, and the muscles surrounding the joint weaken, making it no longer stable. In some cases, the joint becomes immobilized.

  • Arthropathies - types, causes, symptoms, treatment

The most common haemorrhages are ankles, knees and elbows. There may be haemorrhages to other joints, such as toes, hips, and shoulders. Rarely, haemorrhages occur in the joints of the hand (the joints of the hand are most often the site of haemorrhage after an injury). A joint with recurrent bleeding that does not recover between strokes is called a joint.target pond.

Hemophilic arthropathy - symptoms

Recurrent bleeding into the joints is usually preceded by characteristic symptoms such as:

  • feeling of oppression
  • tingling
  • warming the pond

Joint bleeding begins in the first years of life (on average in the 2nd year of life) and is most often observed in the knee, elbow and ankle joints.

In turn, at the moment of bleeding into the joint, they appear:

  • joint swelling of various sizes with palpable fluffiness
  • joint pain
  • limiting the range of motion of the joint

Repeated bleeding leads to haemophilic arthropathy, the symptoms of which are:

  • joint stiffness - especially in the morning or after a long sitting position
  • pain in the joint during movement
  • weakness and atrophy of the muscles surrounding the joint
  • if the arthropathy affects the knee or ankle joint, the patient may have difficulty climbing stairs and getting in and out of vehicles. Running is out of the question

Hemophilic arthropathy - diagnosis

X-rays of the joints are performed, although in recent years, in the diagnosis of patients with hemophilia, magnetic resonance and ultrasound have been increasingly used.

Hemophilic arthropathy - treatment

A patient with haemophilic arthropathy requires the assistance of a medical team consisting of a hematologist, orthopedist, physiotherapist, pain treatment specialist, and psychologist.

When a joint is damaged, it is unlikely that it will ever be he althy again. If a "target joint" develops or synovitis develops, there are several treatments:

Such actions will not reverse degeneration, but may h alt its progression and significantly improve the quality of life of a hemophiliac sufferer.

  • clotting factor treatment
  • exercises developed by a physiotherapist at a hemophilia treatment center. They are used to strengthen the muscles and surrounding joints
  • splint or stabilizer - can be used to protect the joint
  • steroid injection (directly into the joint) to accelerate joint healing
  • synovectomy - a surgical operation to remove the inflamed synovium within a joint or tendon
  • arthrodesis - two bones are connected with screws, steel rods or staples. The joint stiffened in this way loses its flexibility, but it is more stable and can bear the load more, which leads to a reduction in pain
  • joint replacement - may be indicated when there is severe joint damage and loss of mobility

Hemophilic arthropathy - how to prevent it?

Joint bleeding should be prevented by using the prophylactic factorclotting. However, even doing this is not the way to avoid all bleeding, especially in busy children .You can also wear furniture protectors, place carpets on the floor, and use protective accessories (helmets, knee pads). Another way to prevent joint damage is to recognize and treat any fresh joint bleeding immediately.

Bibliography:

1. All about hemophilia. Guide for the family

Category:

Spine, bones, joints