Radiological aspects of musculoskeletal complications in three hemophilic patients with long-term follow-up

Abstract

Objective: The objective of the study is to describe the radiological aspects of musculoskeletal complications of hemophilia found in three patients. Patients and Methods: It is a retrospective review of clinical and radiological records of three known and followed hemophilic patients, whose radiological examinations were carried out and archived on the Picture Archiving and Communication System of the University Hospital. Results: The three patients were male with severe hemophilia A, using recombinant factor VIII replacement therapy on demand, followed during 10 years. Joint bleeding was the most frequent complication. We found hemarthrosis at ultrasound in two patients (one after a minor trauma of the knee and one after repeated traumas of the ankle) and at magnetic resonance imaging (MRI) in the three patients (three in the knee and two in the ankle) and chronic arthropathy in two patients (two in the knee and one in ankle. The muscular lesions detected at ultrasound were hematomas of the left soleus muscle, right vastus medialis muscle, and right rectus abdominis muscle. Conclusion: Bleeding in hemophilic patients affects both muscles and joints, with long-term consequences for the joints. Medical imaging was very useful for the detection and follow-up of joint and muscle lesions in these three patients, based on ultrasound and MRI with T2* sequence.