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Hemophilic Arthritis

A Brief Description

It is a joint disorder that arises when there is a hemophilic bleeding occurring into the joint. In other words, coagulation process becomes very slow. The disease is seen to commonly affect males whereas it is transmitted by females. It is also known as arthropathy. It commonly affects the knees, elbows, and ankles. The developments of hemophilic arthritis can division into two stages. In the first stage, the patient may get intense pain in the affected area and the movement of that area will be limited. In the second stage, it is called chronic synovitis. As a result, there will be a persistent swelling in the joint. It can be mild, moderate or severe. When the chronic synovitis prevails for a long term, it becomes the cause for developing hemophilic arthritis.

Common Signs & Symptoms

The common signs may include:

  • Pain in the joints (knees, elbows, and ankles)
  • Swelling in the joints.
  • Recurrent bleeding and chronic inflammation in some cases.
  • Difficulty while joint movements.
  • Joint cartilage erosion.
  • Joint fibrosis.
  • Joint coalition or fusion.

Classifications

Hemophilic arthritis is classified into:

  • Hemophilia A also known as factor VIII deficiency.
  • Hemophilia B also known as Christmas disease/factor XI deficiency.
  • Von Willebrallds disease: The disease is characterized by improper function of blood platelets.

This kind of arthritis most commonly affects elbow, ankle and knee joints. Hemophilic arthritis is developed when chronic synovitis persists. Chronic synovitis continues when there is a continuous inflammation on the synovial membrane, the membrane that lines the joints. It is seen mainly as the swelling of soft tissue. Other noticeable characteristics are:

  • Osteoporosis
  • Presence of subchondral cysts.
  • Enlarged appearance of Epiphysis relative to Diaphysis.
  • Presence of lesions that resemble a false tumor.
  • Disorganization of a joint like sclerosis, articular fragmentation, bone misalignment etc

Diagnostic Procedures Commonly Employed

This disease is diagnosed on the basis of the following:

  • Preliminary Coagulation Testing: This includes testing the APTT and PT bleeding and clotting time.
  • Diagnosing whether it is hemophilia A or B.
  • Family History: Determination of sex linked disorders.

The disease can be treated using the below mentioned procedures:

  • Local hemostatic agents: Hemostatic agents include gelfoam or thrombin if the site of bleeding can be accessed.
  • Providing adequate factor VIII replacement. For factor VIII replacement, the following products like cryoprecipitates and dried factor VIII concentrates can be used.
    -Non-blood products like synthetic vasopressin etc. can be used.
  • Hemarthritis treatment: This includes inflammation of joints, coagulation factor replacement, physiotherapy etc.
  • Chronic arthropathy treatment: This includes procedures like total joint replacement for severe destruction of joints, steps to reduce the recurrence of bleeding, physiotherapy etc.
  • General care: The procedures like providing a cure for anemia, prophylactic immunization, drugs to prevent bleeding like aspirin come under this category.
  • Drugs that are used to cure arthritis can be used to relieve the excess pain. The main treatment is offered only by consultation with a therapist who expertise in hemophilia. Exercise methods are administered that are used for strengthening the muscles, coordination improvement etc. Through these exercises, range of motion can be improved.
  • Excluding exercises, supportive devices like splints, braces etc can be used. Rather than providing support to the joints, these also help in controlling the bleeding and associated pain in some joints.
  • Preventive measures include early diagnosis and treatment of hemarthrosis. Thereby, chances for the onset of chronic synovitis can be avoided.