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Colegio de Medicina Interna de México.

2012, Number 6

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Med Int Mex 2012; 28 (6)

Utility intra-articular dexamethasone in patients with severe hemophilic arthropathy

Barragán GJA, Pérez CM, Barile-Fabris LA, Duarte MJ, Romero FS, Espinosa LRF, Sánchez RG

Language: Spanish
References: 29
Page: 568-572
PDF size: 169.19 Kb.


ABSTRACT

Background: The main causes of morbidity intra - articular in patients with hemophilia type A or B is the arthropathy by hemarthrosis of repetition, causing disability and alterations in quality of life. Administration of dexamethasone can improve symptoms and articulate the functionality.
Objective: Determine the clinical response and the number of monthly hemarthrosis in most affected joints of patients with haemophilia after dexamethasone intraarticular infiltration.
Material and methods: observational, descriptive study in patients with hemophilia A or B, with severe hemophilia type was carried out ultrasound musculoskeletal (USME) of the joints by detecting which show more synovial proliferation and doppler signal later infiltration intra-articular dexamethasone 16 mg each month for 3 months follow-up was carried out, indicated infiltration after 15 days of complete rest and 15 days of rehabilitation. Evaluated events hemarthrosis, visual analog scale (EVA) patient's pain and the arches of the mobility of the joint affected every month in follow-up for 3 months.The clinical evaluation of joints affected by hemarthrosis measuring mobility arches articulate by means of a universal goniometer at the beginning and at the end of the study.
Results: A total of 8 patients with severe hemophilia (7 type A and type B 1) with an average age of 24 years (17-31), hemarthrosis of knees and elbows 3, 5 where decrease was observed on the eve of patient's pain in 8 patients (81.2 at the beginning of the study and a 3 month 12.5), with improvement in the arches of mobility in 6 patients (3 elbows and knees 3) of which on average in elbows at the beginning of the study were presented: flexion (F) :-30 °, extension (E): - 33.3 °, pronation (P): normal, Supination (S): - 25 °, and the third month the F: average - 13.3 °, E: 11.6 ° and normal q: S: 8.3 °. With regard to knee at the beginning of the study on average presented f - 46 °, 17 ° e and a 3 month was observed: - 31 ° and 10 ° E: Significant decrease in the number of bleeding intra-articular in all patients at the end of the study with average of monthly bleeding at the beginning of the study 5.87 and a 3 month an average of 0.12 was also observed.
Conclusion: The cycle of dexamethasone intraarticular infiltration improves mobility arches, reduces pain and hemarthrosis in follow-up events to 3 months, however one larger sample is required to confirm this conclusion.



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