Learning Radiology xray montage

Hemophiliac Arthritis

  • Christmas disease is indistinguishable except milder  

  • Females can develop hemophilia if hemophiliac male marries female carrier  

  • Hemarthrosis most common in hinge joints, e.g. knee, elbow, ankle  

    • Chronic synovitis develops from repeated intra-articular hemorrhages

    • Thickened synovium produces marginal erosions

    • Multiple subchondral cysts may develop secondary to intraosseous hemorrhage

  • Conventional Imaging
    • X-ray changes due to synovial proliferation and hyperemia

    • Widening of the intercondylar notch of the femur

    • Chronic hyperemia produces enlargement of epiphyses

      • Especially medical condyle

    • Secondary trabeculae are resorbed leaving linear striations in the bone

    • Sometimes hemosiderin in soft tissues may make them appear dens

  • From the increased blood to the epiphyses, the epiphyses may appear too early, grow too large, and fuse early  

  • Juvenile rheumatoid arthritis may simulate hemophilia changes in bone

    • JRA occurs more often in females

hemophiliac arthritis

Hemophiliac Arthritis. There is widening of the intercondylar notch, accentuation of the
trabeculae and enlargement of the medial epicondyle