Role of Musculoskeletal Ultrasound in Detection of Hemophilic Arthropathy

Abstract

Hemophilia is an X-linked congenital bleeding disorder, with hemophilia A (reduced or absent levels of factor VIII) and hemophilia B (reduced or absent levels of factor IX). The disease is classified on bases of the residual circulating factor activity level as: severe (<1%), moderate (1-5%) or mild (5-40%). Severe form of the disease is characterized by spontaneous hemoarthrosis and the resultant hemophilic arthropathy (HA). HA is characterized by soft tissue changes such as synovial hypertrophy and effusion as well as cartilage and bony damage which ultimately result from repeated joint bleeding episodes. It was found that even a single episode of bleeding may impact long-term outcomes of the joints function, and HA still remains a critical research focus as it’s a debilitating disease that negatively impacts quality of life, physical activity as well as bone health of the aging group in PwH. (Bakeer and Shapiro, 2019). MSK-US has many advantages over MRI as its accessibility, wider availability, safety, lower cost of examination and lack of interference of susceptibility artifacts in joints with hemosiderin deposition, including the “blooming” artifact. Therefore, MSK-US has now emerged has emerged as a promising imaging modality for the early detection and management of HA (Di Minno et al., 2016)