Clinical Case Vignettes
Hemophilic arthropathy
Sham Santhanam1*, Madeshwaran M2, Rajeswari Sankaralingam3
Author Affiliations
1Postgraduate, Department of Rheumatology, Madras Medical College, Chennai, India
2Department of Rheumatology, Madras Medical College, Chennai, India
3Professor & HOD, Department of Rheumatology, Madras Medical College, Chennai, India
*Correspondence: Dr. Sham S
IJRCI. 2015;3(1):V1
Received: 26 December 2014, Accepted: 3 January 2015, Published: 8 January 2015
© IJRCI
A 16-year-old boy, born through non-consanguineous marriage, presented with acute onset of left knee joint pain and swelling with no history of fever or trauma. He was a known case of hemophilia A with recurrent attacks of hemarthrosis since 3 years of age involving only the knee joints. His symptoms used to subside when receiving multiple (on demand) factor VIII infusions. Clinical examination revealed that the joints were warm, tender, and swollen. His knee radiography revealed subchondral cysts, widening of intercondylar notch, soft tissue swelling, flattened intercondylar surfaces, erosions, generalized osteopenia on anteroposterior view, and squaring of patella on lateral view (Fig.1 and 2). The findings were suggestive of chronic hemophilic arthropathy.
Fig 1: Plain radiograph anteroposterior view of left knee joint revealing: a) subchondral cysts, b) widening of intercondylar notch, c) soft tissue swelling, flattened intercondylar surfaces, erosions, and generalized osteopenia
Fig 2: Plain radiograph lateral view of left knee joint revealing: a) subchondral cysts, b) erosions and squaring of distal patellar margin with d) soft tissue swelling and generalized osteopenia
Competing interests
The authors declare that they have no competing interests.