Hemophilia x ray: Difference between revisions

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Revision as of 19:00, 22 January 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

An x-ray of the joints in the case of hemophilic arthropathy may be helpful in the diagnosis of hemophilia. Pettersson scoring system, designed in 1980, is widely applied for the classification of osteochondral changes of hemophilic arthropathy in elbows, knees, and ankles. This scoring system is based on typical findings of hemophilic arthropathy on posterior-anterior and lateral x-rays. Arnold-Hilgartner classification is a plain radiograph grading system for hemophilic arthropathy of the knee.

X Ray

An x-ray of the joints in the case of hemophilic arthropathy may be helpful in the diagnosis of hemophilia.
Pettersson scoring system, designed in 1980 and based on typical findings of hemophilic arthropathy on posterior-anterior and lateral x-rays, is widely applied for the classification of osteochondral changes of hemophilic arthropathy.^[1]

Classification of hemophilic arthropathy according to the Pettersson score^[1]


Finding	Interpretation

Osteoporosis	Absent = 0 Present = 1
Enlargement of epiphysis	Absent = 0 Present = 1
Irregularity of subchondral surface	Absent = 0 Partially involved = 1 Totally involved = 2
Narrowing of joint space	Absent = 0 Joint space > 1 mm = 1 Joint space < 1 mm = 2
Subchondral cysts formation	Absent = 0 1 cyst = 1 >1 cyst = 2
Erosion of joint margins	Absent = 0 Present = 1
Gross incongruence of articulating bone ends	Absent = 0 Slight = 1 Pronounced = 2
Joint deformity (angulation and/or displacement)	Absent = 0 Slight = 1 Pronounced = 2

Arnold-Hilgartner scale of hemophilic arthropathy^[2]


Stage	Findings

Stage 0	Normal joint
Stage I	No skeletal abnormalities Soft-tissue swelling is present
Stage II	Osteoporosis and overgrowth of the epiphysis No cysts No narrowing of the cartilage space
Stage III	Early subchondral bone cysts Squaring of the patella Widened notch of the distal femur or humerus Preservation of the cartilage space
Stage IV	Findings of stage III, but more advanced; narrowed cartilage space
Stage V	Fibrous joint contractures Loss of the joint cartilage space Extensive enlargement of the epiphyses with substantial disorganization of the joint

Images

Hemophilic arthropathy involving the bilateral knees - Source: radswiki.net
Hemophilic arthropathy involving the bilateral knees
Hemophilic arthropathy involving the bilateral knees
Hemophilic arthropathy involving the bilateral knees

X-ray of the ankle in a patient with Hemophilia
X-ray of the ankle in a patient with Hemophilia
X-ray of the ankle in a patient with Hemophilia

X-ray of the knee in a patient with Hemophilia
X-ray of the knee in a patient with Hemophilia

References

↑ ^1.0 ^1.1 Pettersson H, Ahlberg A, Nilsson IM (June 1980). "A radiologic classification of hemophilic arthropathy". Clin. Orthop. Relat. Res. (149): 153–9. PMID 7408294.
↑ Arnold WD, Hilgartner MW (April 1977). "Hemophilic arthropathy. Current concepts of pathogenesis and management". J Bone Joint Surg Am. 59 (3): 287–305. PMID 849938.

Template:WH Template:WS

[pmid7408294-1] 1.0 ^1.1 Pettersson H, Ahlberg A, Nilsson IM (June 1980). "A radiologic classification of hemophilic arthropathy". Clin. Orthop. Relat. Res. (149): 153–9. PMID 7408294.

[pmid849938-2] Arnold WD, Hilgartner MW (April 1977). "Hemophilic arthropathy. Current concepts of pathogenesis and management". J Bone Joint Surg Am. 59 (3): 287–305. PMID 849938.

[1]

[2]

@@ Line 4: / Line 4: @@
 ==Overview==
-An x-ray of the joints in the case of hemophilic arthropathy may be helpful in the diagnosis of hemophilia. Pettersson scoring system, designed in 1980, is widely applied for the classification of osteochondral changes of hemophilic arthropathy in elbows, knees, and ankles. This scoring system is based on typical findings of hemophilic arthropathy on posterior-anterior and lateral x-rays.
+An x-ray of the joints in the case of hemophilic arthropathy may be helpful in the diagnosis of hemophilia. Pettersson scoring system, designed in 1980, is widely applied for the classification of osteochondral changes of hemophilic arthropathy in elbows, knees, and ankles. This scoring system is based on typical findings of hemophilic arthropathy on posterior-anterior and lateral x-rays. Arnold-Hilgartner classification is a plain radiograph grading system for hemophilic arthropathy of the knee.
 ==X Ray==
@@ Line 64: / Line 64: @@
 |-
 |}
+''' Arnold-Hilgartner scale of hemophilic arthropathy'''<ref name="pmid849938">{{cite journal |vauthors=Arnold WD, Hilgartner MW |title=Hemophilic arthropathy. Current concepts of pathogenesis and management |journal=J Bone Joint Surg Am |volume=59 |issue=3 |pages=287–305 |date=April 1977 |pmid=849938 |doi= |url=}}</ref>
+{| style="border: 0px; font-size: 90%; margin: 3px; width:450px"
+| valign="top" |
+|+
+! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
+! style="background: #4479BA; width: 330px;" | {{fontcolor|#FFF|Findings}}
+|-
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Stage 0
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Normal joint
+|-
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" align="center" |Stage I
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*No skeletal abnormalities
+*Soft-tissue swelling is present
+|-
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Stage II
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Osteoporosis and overgrowth of the epiphysis
+*No cysts
+*No narrowing of the cartilage space
+|-
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Stage III
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Early subchondral bone cysts
+*Squaring of the patella
+*Widened notch of the distal femur or humerus
+*Preservation of the cartilage space
+|-
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Stage IV
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Findings of stage III, but more advanced; narrowed cartilage space
+|-
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Stage V
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Fibrous joint contractures
+*Loss of the joint cartilage space
+*Extensive enlargement of the epiphyses with substantial disorganization of the joint
+|-
+|}