Standardized ultrasonography of joints and correlation with joint function in children and young adults with haemophilic arthropathy – first results of a clinical pilot trial at a german treatment center

Purpose: Sonography is used in routine clinical practice to examine joint bleedings or signs of haemophilc arthropathy (HA) with effusion, synovitis, cartilage defects or subchondral bone damage in patients with bleeding disorders. For the presentation of synovitis or effusions as a sign of activity and defects of the articular cartilage or subchondral bone as a sign of progression of HA standardized sonographic section planes are available. In this study the sonographic findings are correlated with data from an ultrasonic motion-analysis of the knees and the results of an orthopedic examination.

Material and methods: First experiencies were made in a group of 27 young german patients (3 – 28 years, median 13.1) with hemophilia A, B or von Willebrand's disease. A standardized ultrasonography of the elbow, knee and ankle joints with a Zonare z.one ultrasound machine (transducer L14 – 5w) and simultaneously a clinical examination and a motion analysis of the knees were performed. Joint ultrasound characteristics were scored (HEAD-US-Score developed by C. Martinoli). Motion analysis of the knees were done with the Ultrasound-Topometer and scored also. The scores and the results of the orthopedic examination were correlated.

Results: The results of various studies indicate an age-dependent correlation of ultrasound and motion analysis. Joint sonography shows some changes already before detecting in clinical examination.

Fig. 1: clinical examination

Conclusion: Initial studies of correlating a standardized ultrasonography of disease activity in HA and joint function analysis showed age-dependent promising results. These results were encouraging to examine the correlation now in a larger group of young patients in germany (HämarthroSonoPilotTrial).