Hemophilia

  • Etiology: bleeding into joint -> synovial proliferation + dissolving of articular cartilage -> joint space narrowing + sclerosis
  • Imaging: 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 + premature closure of growth plate
  • MRI: blooming synovial nodules (blood products)
  • DDX: juvenile idiopathic arthritis, sickle cell disease, septic joint

Radiology Cases of Hemophilia

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.