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Colegio de Medicina Interna de México.

2013, Number 4

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Med Int Mex 2013; 29 (4)

Cynical, X-ray and Ultrasonographic Assessment in Hemophilic Arthropathy and Its Correlation with the Severity of the Disease

Barragán-Garfias JA, Pérez-Cristóbal M, Camargo-Coronel A, Vázquez-Zaragoza MÁ, Barile-Fabris L, Duarte-Mote J, Jiménez-Andrade MC, Sánchez-Rojas G, Espinosa-López RF, Romero-Figueroa S

Language: Spanish
References: 16
Page: 356-362
PDF size: 200.90 Kb.


ABSTRACT

Background: The main reason of morbidity in haemophilic patients is recurrent haemarthrosis arthropathy, causing disability and life quality impairment. Musculoskeletal ultrasound helps detect early and later changes in patients with haemophilic arthropathy.
Objective: To determine the role of the musculoskeletal ultrasound in haemophilic arthropathy compared to clinic and radiographic features of the affected joints.
Material and method: A prospective observational and descriptive study was done with type A or B haemophilic patients from June 2008 to April 2009. Thirty-nine patients with mild haemophilia (n = 6, 15.3%), moderate haemophilia (n = 6, 15.3%) and severe haemophilia (n = 27, 69.2%) were included. Clinical, radiographic and ultrasonographic assessment was done to all patients.
Results: In the knees of patients with severe haemophilia we observed: increased soft tissue in 53.7% and 20.4% with musculoskeletal ultrasound and radiographic study, respectively (p = 0.0006), decreased joint space in 59.2% and 42.6% with musculoskeletal ultrasound and radiographic study, subchondral sclerosis in 9.2% and 3.7% with musculoskeletal ultrasound and radiographic study, noting flexion and extension restriction in 44.4% of patients. In the elbow, increased soft tissue was seen in 7.4% and 3.7% with musculoskeletal ultrasound and radiographic study; decreased joint space occurred in 25.9% and 16.6% with musculoskeletal ultrasound and radiographic study; subchondral sclerosis in 3.7% with musculoskeletal ultrasound and 0% with radiographic study. Among patients with moderate and mild haemophilia (six patients each group), there was history of haemarthrosis only in knees, and the following was observed by musculoskeletal ultrasound and radiographic studies, respectively: increased soft tissue: 33% and 0%, decreased joint space: 33% and 16.6%, subchondral sclerosis: 33% and 0%.
Conclusions: In the studied joints, musculoskeletal ultrasound showed a higher joint pathology compared to X-ray study and physical examination, so, it is a useful tool in the initial assessment of patients with haemophilic arthropathy.


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