Muscle Hemorrhage
Overview:
Bleeding into the muscle. More insidious and massive than hemarthrosis. Common in flexor groups: iliopsoas, gastroc, flexor surface of forearm.
Causes:
Hereditary blood-clotting disorder related to abnormality of plasma proteins: factors VIII and IX
Risk Factors:
History of Hemophilia
Pathogenesis:
The plasma proteins factors VIII and IX are present in the blood but are not functional to clot blood. Blood is released out of muscle tissue
Examination:
Signs and Symptoms:
Gradual intensifying pain, protective spasm of muscle, joint limitation, muscle assumes shortened position, loss of sensation
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
Recurrent Illnesses: Likely
Diagnostic Tests/Imaging/Tests and Measures:
Observed changes in hands and nail beds
Skin: white waxy appearance-acute hemorrhage
Nails: spoon nails
Blood work
Joint Range of Motion with identification of end-feel
References
Bleeding into the muscle. More insidious and massive than hemarthrosis. Common in flexor groups: iliopsoas, gastroc, flexor surface of forearm.
Causes:
Hereditary blood-clotting disorder related to abnormality of plasma proteins: factors VIII and IX
Risk Factors:
History of Hemophilia
Pathogenesis:
The plasma proteins factors VIII and IX are present in the blood but are not functional to clot blood. Blood is released out of muscle tissue
Examination:
Signs and Symptoms:
Gradual intensifying pain, protective spasm of muscle, joint limitation, muscle assumes shortened position, loss of sensation
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
Recurrent Illnesses: Likely
Diagnostic Tests/Imaging/Tests and Measures:
Observed changes in hands and nail beds
Skin: white waxy appearance-acute hemorrhage
Nails: spoon nails
Blood work
Joint Range of Motion with identification of end-feel
References