Pediatric Hemophilia

  • Etiology: Bleeding into joint leads to synovial proliferation and dissolving of articular cartilage leads to joint space narrowing and sclerosis
  • Imaging Radiograph: Affects knee, elbow, ankle
    — Initially see distension of joint capsule with dense joint effusion, periarticular osteoporosis, widened intercondylar notch due to condyle overgrowth, squaring of patella
    — Eventually see joint space narrowing, subchondral cyst, osteophyte, epiphyseal overgrowth and premature closure of growth plate
    — Classically chronic joint irregularity and overgrowth
  • Imaging MRI: Blooming synovial nodules due to blood products
  • DDX: Juvenile idiopathic arthritis, sickle cell disease, septic joint
  • Complications:
  • Treatment:
  • Clinical:

Radiology Cases of Hemophilia

Radiology Cases of Hemophilia With Knee Joint Effusion

Radiograph of hemophilia in the knees
AP (above) and lateral (below) radiographs of the knees show knee joint capsular distension due to dense effusions (left > right), periarticular osteopenia, joint space narrowing, subchondral cysts and epiphyseal overgrowth.

Radiology Cases of Hemophilia With Hemorrhage Into Calf

MRI of hemophilia with hemorrhage in the calfs
Axial T2 fat sat (above) and axial GRE (below) MRI of the lower extremities shows symmetric bilateral increased T2 signal and gradient echo blooming primarily in the superfical and posterior deep compartments bilaterally.