Hemophilic arthropathyHemophilic arthropathyLocation:Knee elbow ankle hip shoulder.Distribution:Unilateral or bilateral asymmetrical (DDx with JRA).
Radiological manifestiation ofhemophilic arthropathyDense joint effusion HemoarthrosisJuxta-articular osteoporosis. Hyperemia of theepiphysisEnlargement of the epiphysis Hyperemia of theepiphysisDiffuse narrowing of the jointspaceCartilage destructionIrregular articular surfaces Bone erosionSubchondral sclerosis, cysticchanges and marginalosteophytic lipping.Premature 2ryosteoarthritis.
MRIMRILow signal intensity of the hypertrophied synovium on allpulse sequences due to siderotic synoviitis.
KneeKnee16 +Bulbous femoral condyles with flattened inferior surface.Slanting of the tibial plateau.Widening of the intercondylar notch (due to repeatedhemorrhage in the attachments of the cruciate ligaments).Squaring of the lower pole of the patella.
ElbowElbow16 +Widening of the trochlear & ulnar notches.Enlargement of the radial head.
AnkleAnkle16 +Talar tilt: medial slanting of the tibiotalar joint withalteration of ankle mortise.
MRIMRI1. Hemorrhagic joint effusion.2. Synovial hemosiderin deposition (low signal intensity onall pulse sequences with blooming artifact on gradientecho images).3. Destruction of the articular surface.4. Bone marrow edema of the epiphysis.
Complications of hemophilicComplications of hemophilicarthropathy:arthropathy:1. Premature 2ry osteoarthritis.2. Premature fusion of the epiphysis with limb shortening.3. Avascular bone necrosis.4. Septic arthritis.
DD of hemophiliaJRANeuromuscular disorders.Neuromuscular disordresimmobilizationSynovial atrophy Vascular stasisEpiphysealenlargementDecreasedcartilage nutrition