Hemarthrosis
| Hemarthrosis | |
|---|---|
| Specialty | Rheumatology  |
Hemarthrosis (or haemarthrosis) is a bleeding into joint spaces. It is a common feature of Hemophilia. The presence of it excludes the Idiopathic thrombocytopenic purpura (ITP).
Causes
It usually follows injury but occurs mainly in patients with a predisposition to hemorrhage such as those being treated with warfarin (or other anticoagulants) and patients with hemophilia.
It can be associated with knee joint arthroplasty.[1]
It has also been reported as a part of hemorrhagic syndrome in the Crimean-Congo Hemorrhagic Fever, suggesting a viral cause to the bleeding in a joint space.[2][3]
Diagnosis
Hemarthrosis is diagnoised through below ways -
A physical examination is the first step, the joints of the patient are moved and bent to see the functioning.[4]
Treatment
In hemophilia it may occur spontaneously, and recurrent hemarthroses are a major cause of disability in that patient group due to hemophilic arthropathy, requiring synovectomy, joint replacement[5] and increased medical therapy to prevent further bleeding episodes.
Reducing hemarthroses events using intravenous administration of blood clotting factor concentrate on a regular basis starting in early childhood, reduces joint deterioration and increases the person's quality of life compared to "on demand" treatment (treating after a bleed).[6] The minimal effective dose and best dosage frequency have not been established.[6] It is not clear, due to lack of sufficient data, if preventative therapy with clotting factor concentrate is also effective at reducing joint deterioration if treatment is started after joint damage has occurred.[6]
Complications
Up to a quarter of all severe ligament or capsular knee injuries leading to a haemarthrosis are associated with cartilage damage that can lead to progressive degenerative arthritis.[7]
-
X-ray of Hemarthrosis -
X-ray of Hemarthrosis
References
- ^ Ohdera T, Tokunaga M, Hiroshima S, Yoshimoto E, Matsuda S (2004). "Recurrent hemarthrosis after knee joint arthroplasty: etiology and treatment". J Arthroplasty. 19 (2): 157–61. doi:10.1016/j.arth.2003.09.009. PMID 14973857.
- ^ Ahmeti, Salih; Ajazaj-Berisha, Lindita; Halili, Bahrije; Shala, Anita (Apr 2014). "Acute arthritis in Crimean-Congo hemorrhagic fever". Journal of Global Infectious Diseases. 6 (2): 79–81. doi:10.4103/0974-777X.132052. PMC 4049045. PMID 24926169.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ Heyman, Paul; Cochez, Christel; Hofhuis, Agnetha; van der Giessen, Joke; Sprong, Hein; Porter, Sarah Rebecca; Losson, Bertrand; Saegerman, Claude; Donoso-Mantke, Oliver; Niedrig, Matthias; Papa, Anna (2010). "A Clear and Present Danger: Tick-borne Diseases in Europe". Expert Rev Anti Infect Ther. 8 (1): 33–50. doi:10.1586/eri.09.118. PMID 20014900.
- ^ "Hemarthrosis". Healthline. Retrieved 2017-11-21.
- ^ Dunn AL (Sep 2005). "Management and prevention of recurrent hemarthrosis in patients with hemophilia". Current Opinion in Hematology. 12 (5): 390–4. doi:10.1097/01.moh.0000169285.66841.c8. PMID 16093785.
- ^ a b c Iorio, Alfonso; Marchesini, Emanuela; Marcucci, Maura; Stobart, Kent; Chan, Anthony Kc (2011-09-07). "Clotting factor concentrates given to prevent bleeding and bleeding-related complications in people with hemophilia A or B". The Cochrane Database of Systematic Reviews (9): CD003429. doi:10.1002/14651858.CD003429.pub4. ISSN 1469-493X. PMID 21901684.
- ^ Goldberg A, Stansby G "Surgical Talk" 2nd edition