Value of magnetic resonance imaging for the diagnosis and follow-up of haemophilic arthropathy.
An orthopaedic assessment of the joint status of seven severe haemophiliacs (mean age 12.5 y - range 8.9-15.5) on prophylactic treatment (PT) by magnetic resonance imaging (MRI) and physical examination was carried out. Median duration of PT of these patients was 84 months (range 32-107). A locally designed MRI joint score considering seven parameters (1 - joint effusion, 2 - synovial membrane thickening, 3 - haemosiderin deposits, 4 - joint cartilage injury, 5 - subchondral bone erosion, 6 - subchondral bone cysts, 7 - osteonecrosis) was used (maximum score = 13 points). MRI scans were performed in 17 joints (nine ankles, seven knees and one elbow): mean MRI scores for the affected joints was 5.1. A poor consistency between physical examination and MRI findings or the real extent of joint damage was found (Cohen kappa index 0.320). MRI is a precise non-invasive tool for the assessment of early joint cartilage and synovium pathological changes still undetectable by physical examination or conventional X-rays in the haemophilic setting.
Dobón
M
M
Department of Haematology, Hospital Miguel Servet, Zaragoza, Spain.
Lucía
J F
JF
Aguilar
C
C
Mayayo
E
E
Roca
M
M
Solano
V
V
Peña
A
A
Giralt
M
M
Ferrández
A
A
D000293:Adolescent; D002648:Child; D005164:Factor IX / Q000627:therapeutic use; D005169:Factor VIII / Q000627:therapeutic use; D005500:Follow-Up Studies; D006395:Hemarthrosis / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D006467:Hemophilia A / Q000150:complications*; D002836:Hemophilia B / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010808:Physical Examination / Q000379:methods; D011446:Prospective Studies
D005169:Factor VIII; D005164:Factor IX