Hemarthrosis
Overview:
Bleeding into the joint. The most common clinical manifestation of Hemophilia
Common joints:
knee, elbow, ankle, hip, and shoulder (order of most to least common)
Causes:
Hereditary blood-clotting disorder related to abnormality of plasma proteins: factors VIII and IX
Risk Factors:
Famiily history of Hemophilia
Pathogenesis:
The plasma proteins factors VIII and IX are present in the blood but are not functional to clot blood. Individuals bleed at the same rate as others but bleed longer than others.
Examination:
Signs and Symptoms: tingling or prickling feeling, stiffening into the position of comfort, pain. swelling, tenderness, heat
History:
Past Hx: chemotherapy or radiation therapy, chronic long term use of NSAIDs, spontaneous bleeding of any kind, recent major surgery, rapid onset of
dyspnea, chest pain, weakness and fatigue with palpitations with change in altitude.
Family Hx: Hemophilia
Medications: Factor Replacement
Recurrence: High likelihood
Diagnostic Tests/Imaging/Tests and Measures
Observed changes in hands and nail beds
Skin: white waxy appearance-acute hemorrhage
Nails: spoon nails
Blood work for identification of factors VIII and IX
References
Bleeding into the joint. The most common clinical manifestation of Hemophilia
Common joints:
knee, elbow, ankle, hip, and shoulder (order of most to least common)
Causes:
Hereditary blood-clotting disorder related to abnormality of plasma proteins: factors VIII and IX
Risk Factors:
Famiily history of Hemophilia
Pathogenesis:
The plasma proteins factors VIII and IX are present in the blood but are not functional to clot blood. Individuals bleed at the same rate as others but bleed longer than others.
Examination:
Signs and Symptoms: tingling or prickling feeling, stiffening into the position of comfort, pain. swelling, tenderness, heat
History:
Past Hx: chemotherapy or radiation therapy, chronic long term use of NSAIDs, spontaneous bleeding of any kind, recent major surgery, rapid onset of
dyspnea, chest pain, weakness and fatigue with palpitations with change in altitude.
Family Hx: Hemophilia
Medications: Factor Replacement
Recurrence: High likelihood
Diagnostic Tests/Imaging/Tests and Measures
Observed changes in hands and nail beds
Skin: white waxy appearance-acute hemorrhage
Nails: spoon nails
Blood work for identification of factors VIII and IX
References
