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Case Reports
. 2025 Mar 20;20(6):2855-2860.
doi: 10.1016/j.radcr.2025.02.089. eCollection 2025 Jun.

Shadows of the bleeding joint: A radiologic exploration

Pratiksha Sachani  1 , Rajasbala Dhande  1 , Pratapsingh Parihar  1 , Paschyanti Kasat  1 , Utkarsh Pradeep  2
Affiliations
Case Reports

Shadows of the bleeding joint: A radiologic exploration

Pratiksha Sachani et al. Radiol Case Rep. .

Abstract

Hemophilia is a genetic disorder that manifests due to a deficiency of clotting factors. One of the most common complications is hemophilic arthropathy which results in bleeding into large joints causing hemosiderin deposition. Recurrent hemarthrosis causes joint destruction resulting in pain and a decreased range of movements. Radiological imaging is essential for staging, prognostication, and treatment protocol. X-rays show the extent of joint destruction and narrowing of joint space. Ultrasonography helps in visualizing tendons and joint effusion. However magnetic resonance imaging is the gold standard for staging hemophilic arthropathy. Management involves both medical and surgical intervention as per the level of joint involvement.

Keywords: Arthroplasty; Clotting; Hemarthrosis; Hemophilia; Osteoarthritis.

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Figures

Fig 1:
Fig. 1
X-ray anteroposterior view left- knee joint shows an interlocking nail in situ. X-ray anteroposterior bilateral knee shows changes of osteoarthritis (left >right) in the form of marginal osteophytes, loss of joint space, and subchondral sclerosis. There was a widening of the inter-condylar notch and flattened condylar surface (blue circles).
Fig 2:
Fig. 2
X-ray of right shoulder joint anteroposterior view shows erosive destruction of right humeral head with loss of contour, subchondral cysts, and erosions of visualized part including greater and lesser tuberosity and glenoid margins (blue arrow).
Fig 3:
Fig. 3
X-ray left shoulder joint anteroposterior view appears normal.
Fig 4:
Fig. 4
MRI of right shoulder joint T1 sequence shows erosive destruction of the right humeral head with loss of contour, articular cartilage, and erosions of the visualized part including greater and lesser tuberosity and glenoid margins (red circle).
Fig 5:
Fig. 5
MRI right shoulder Coronal section (A) T1, (B) T2, (C) PDFS shows: hypointensity on T1/T2/PDFS in the tendon of supraspinatus, subscapularis and long head of biceps (red circles).
Fig 6:
Fig. 6
MRI right shoulder joint, Coronal sections SWI sequence shows: the tendon of supraspinatus (blue arrow), subscapularis (pink arrow), long head of biceps (yellow arrow), infraspinatus (red arrow) and teres minor (green arrow) at the insertion site showing blooming on SWI suggestive of hemosiderin deposition.
Fig 7:
Fig. 7
MRI right shoulder axial section T2 sequence shows joint effusion (blue arrow).
See this image and copyright information in PMC

References

    1. Peyvandi F., Garagiola I., Young G. The past and future of haemophilia: diagnosis, treatments, and its complications. Lancet. 2016;388(10040):187–197. doi: 10.1016/S0140-6736(15)01123-X. - DOI - PubMed
    1. Thachil J., Connors J.M., Mahlangu J., Sholzberg M. Reclassifying hemophilia to include the definition of outcomes and phenotype as new targets. J Thromb Haemost. 2023;21(7):1737–1740. doi: 10.1016/j.jtha.2023.03.016. - DOI - PubMed
    1. Kaur R., Dahuja A., Singh P., Aggarwal S. Hemophilic arthropathy of the knee: a case report with discussion on the role of imaging with review of literature. J Clin Sci. 2019;16:101–104.
    1. Zubieta J.A., Galindo-Rodriguez G., Lavalle C. Rheumatic manifestations of hematologic disorders. Curr Opin Rheumatol. 1998;10(1):86–90. doi: 10.1097/00002281-199801000-00013. - DOI - PubMed
    1. Stephensen D., Tait R.C., Brodie N., Collins P., Cheal R., Keeling D., et al. Changing patterns of bleeding in patients with severe haemophilia A. Haemophilia. 2009;15(6):1210–1214. - PubMed

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