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. 2023 Jul 18:10:1193830.
doi: 10.3389/fmed.2023.1193830. eCollection 2023.

Comparison of joint status using ultrasound assessments and Haemophilia Joint Health Score 2.1 in children with haemophilia

Yanju Li  1 , Feiqing Wang  2   3 , Chengyun Pan  1 , Jing Zhang  1 , Qian Zhang  1 , Lingying Ban  1 , Lingling Song  1 , Jishi Wang  1 , Zhixu He  4 , Xiaojing Zeng  1 , Dongxin Tang  2 , Yang Liu  2   4
Affiliations

Comparison of joint status using ultrasound assessments and Haemophilia Joint Health Score 2.1 in children with haemophilia

Yanju Li et al. Front Med (Lausanne). .

Abstract

Introduction: Ultrasound (US) has gained popularity in the evaluation of haemophilic joint diseases because it enables the imaging of soft-tissue lesions in the joints and bone-cartilage lesions. We aimed to determine the correlation between US evaluations and clinical assessments performed using HJHS 2.1 and to evaluate their respective characteristics in assessing early haemophilic arthropathy.

Methods: A total of 178 joints (32 knees, 85 elbows, and 61 ankles) in 45 haemophilia A patients (median age, 10 years; range, 6-15) were assessed using US and HJHS 2.1. Ultrasonographic scoring was performed in consensus assessments by one imager by using the US scores.

Results: The total HJHS 2.1 and US scores showed a strong correlation (rS=0.651, P=0.000, CI: 0.553-0.763), with an excellent correlation for the elbows (rS=0.867, P=0.000, CI: 0.709-0.941) and a substantial correlation for the knees (rS=0.681, P=0.000, CI: 0.527-0.797). The correlation for the ankles was relatively moderate (rS=0.518, P=0.000, CI: 0.308-0.705). Nine subjects (15.5%) without abnormalities, as indicated by HJHS 2.1, showed haemophilic arthropathy in US scoring. All nine joints showed moderate (1/9) to severe (8/9) synovial thickening in the ankle (5/9) and elbow joints (4/9). In contrast, 50 joints (50.5%) showed normal US scores and abnormal changes as indicated by HJHS 2.1. S scores correlated well with HJHS 2.1 for overall and individual joints.

Discussion: US could identify some early pathological changes in joints showing normal clinical findings, but still cannot replace the HJHS; however, it can serve as an imaging examination complementing HJHS 2.

Keywords: Haemophilia Joint Health Score (HJHS); arthropathy; children; haemophilia; ultrasonography.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Scatter plot showing the correlation between the total clinical Hemophilia Joint Health Score (HJHS 2.1) and ultrasound (US) scores.
Figure 2
Figure 2
Scatter plot showing the correlation between the clinical Hemophilia Joint Health Score (HJHS 2.1) and ultrasound (US) score for the elbow.
Figure 3
Figure 3
Scatter plot showing the correlation between the clinical Hemophilia Joint Health Score (HJHS 2.1) and ultrasound (US) score for the knee.
Figure 4
Figure 4
Scatter plot showing the correlation between the clinical Hemophilia Joint Health Score (HJHS 2.1) and ultrasound (US) score for the ankle.
See this image and copyright information in PMC

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