title: An acutely painful elbow as a first presentation of von Willebrand's disease.
abstract: A 26 year old woman presented to the accident and emergency department with a painful right elbow. There had been no history of trauma. Clinical examination suggested an effusion, which was confirmed on radiological examination. Her elbow was aspirated and revealed a haemarthrosis. Subsequent investigations revealed a diagnosis of von Willebrand's disease (vWD). A spontaneously occurring effusion of the elbow may be due to a haemarthrosis. Aspiration of blood in the absence of trauma may lead to a diagnosis of an occult coagulopathy in addition to relieving pain. The diagnosis and treatment of vWD is discussed.
authors: Department of Accident and Emergency Medicine, Royal Sussex County Hospital, Brighton.
authors: H D
authors: HD
authors: Poncia
authors: J
authors: J
authors: Ryan
mesh_terms: D000208:Acute Disease; D000328:Adult; D018771:Arthralgia / Q000209:etiology*; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004551:Elbow Joint; D005260:Female; D006395:Hemarthrosis / Q000175:diagnosis*; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D014842:von Willebrand Diseases / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D006490:Hemostatics; D003894:Deamino Arginine Vasopressin