Journal of Blood Medicine (Oct 2022)
Hemophilic Arthropathy: Barriers to Early Diagnosis and Management
Abstract
Rubén Cuesta-Barriuso,1,2 Elena Donoso-Úbeda,3 Javier Meroño-Gallut,4 Roberto Ucero-Lozano,5 Raúl Pérez-Llanes3 1Department of Surgery and Medical-Surgical Specialties, University of Oviedo, Oviedo, Spain; 2Royal Victoria Eugenia Foundation, Madrid, Spain; 3Department of Physiotherapy, Catholic University San Antonio-UCAM, Murcia, Spain; 4Physiotherapy Service, Tu Bienestar 360°, Murcia, Spain; 5Department of Physiotherapy, European University of Madrid, Madrid, SpainCorrespondence: Rubén Cuesta-Barriuso, Department of Surgery and Medical-Surgical Specialties, University of Oviedo, Campus de El Cristo s/n, Faculty of Medicine, Oviedo, 33006, Spain, Tel +34 985 103 386, Email [email protected]: Hemophilia is a congenital coagulopathy characterized by a deficiency of one of the clotting factors. It is characterized by the development of hematomas and hemarthrosis, either spontaneously or after minor trauma. The recurrence of hemarthroses leads to progressive and degenerative joint damage from childhood (hemophilic arthropathy). This arthropathy is characterized by disabling physical effects that limit the functionality and quality of life of these patients. Medical progress achieved over the last decade in the drug treatment of hemophilia has improved the medium and long-term prospects of patients with more effective and long-lasting drugs. The universal use of safer, more effective and prolonged prophylactic treatments may promote the prevention of bleeding, and also therefore, of the development of hemarthrosis and joint damage. A number of imaging instruments have been developed for the assessment of hemarthrosis and hemophilic arthropathy, using ultrasound, magnetic resonance imaging and simple radiology. Different physical examination scores and questionnaires allow the assessment of joint health, self-perceived activity and functionality of patients with hemophilia. The approach to these patients should be interdisciplinary. Assessment of the processes that affect pain in these patients and the development of pain education models should be implemented. Expert advice and information to patients with hemophilia should be based on individual functional prevention diagnoses, advice on available therapies and sports practice, as well as health recommendations.Keywords: hemophilia, joint disease, pain, diagnosis, management