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Adolescent Hip Pain

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
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