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    Go to the top of the page   ID: 20031026194110 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Hemophilic arthropathy (MRI findings)
    Wolfgang Hirsch, S Horneff. Hemophilic arthropathy (MRI findings). PedRad [serial online] vol 3, no. 10.
    URL: www.PedRad.info/?search=20031026194110


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Wolfgang Hirsch, S. Horneff (Leipzig/Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    N/A  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    Leg-Bones  

     
     Pediatric Radiology CasesMost likely etiology:

    physical  

     
     Pediatric Radiology CasesHistory:

    After trauma: Swelling in the traumatized joint, no fever, no pain, but a feeling of pressure and decreased range of movement.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Factor XIII or Factor IX deficiency, in serious cases <1% of the normal value.

    After hemorrhage, usually resoprtion, hypertrophy of the synovia, hyperplasia. Possibly widening of the synovia and cartilage.

    Hemosiderine deposition in the synovia.

    Late findings: Destruction of cartilage. Resorption in the lamella. Cyst formation with hemorrhagic rests, collagen or gelatinous tissue.  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: Knee Joint: Hemorrhage with proof of fluid in the suprapatellar recessus. (T2-TIRM sag).




    MRI 2 <- view MRI 2

    MRI 2: Knee Joint: T1-SE after contrast with fat saturation: Hypertrophy of the synovia, hyperplasia. Some widening of the synovia onto the cartilage.




    MRI 3 <- view MRI 3

    MRI 3: Shoulder Joint: T2-GE. Hemosiderin deposition in the Synovia.




    MRI 4 <- view MRI 4

    MRI 4: Knee Joint: T2-TIRM: Late cartilaginous destruction. Resorption at the border lamella. Cystic development with hemorrhagic rest, collagen, or gelatinous tissue. (Arrows)




    MRI 5 <- view MRI 5

    MRI 5: Upper Ankle Joint: T2-TIRM: Cartilaginous destruction. Resorption at the border lamella. Cystic development with hemorrhagic rest, collagen, or gelatinous tissue.




    MRI 6 <- view MRI 6

    MRI 6: Elbow: DESS: Cartilaginous destruction. Resorption at the border lamella. Cystic development with hemorrhagic rest, collagen, or gelatinous tissue.




    MRI 7 <- view MRI 7

    MRI 7: Upper Ankle Joint: T2-TIRM: Marrow edema with contrast uptake near the articulation, probably after intraossic hemorrhage.




    MRI 8 <- view MRI 8

    MRI 8: Knee: T2-TIRM: Marrow edema with contrast uptake near the articulation, probably after intraossic hemorrhage.




    MRI 9 <- view MRI 9

    MRI 9: Upper Ankle Joint: T2-TIRM: Marrow edema with contrast uptake near the articulation, probably after intraossic hemorrhage. The talus on the right side shows small dissicated osteochondrosis.




    MRI 10 <- view MRI 10

    MRI 10: Upper Ankle Joint: T1-SE after contrast with fat saturation: Marrow edema with contrast uptake near the articulation, probably after intraossic hemorrhage.




    MRI 11 <- view MRI 11

    MRI 11: Upper Ankle Joint: T2-TIRM: Arthrotic marginal spikes and joint incongruencies.




    MRI 12 <- view MRI 12

    MRI 12: T2-GE with FS: Elbow Joint: Metaphyseal widening (due to inflammatory hyperemia)




    MRI 13 <- view MRI 13

    MRI 13: Pseudotumor in the soft tissues. T2-TIRM and T1-SE after contrast and fat saturation (arrows)

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Laboratory diagnostics  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    rheumatoid arthritis.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Even through constant substitution, hemorrhages cause change in the joints after 14 years of age.  

     
     Pediatric Radiology CasesComments of the author about the case:

    Pettersson-Score (X-Ray 0-13 points)

    Osteoporosis
    yes: 1

    Epiphyseal widening
    yes: 1

    Irregular subchondral bone surface
    incomplete: 1
    complete: 2

    Joint gap:
    Gap > 1mm: 1
    Gap < 1mm 2

    Subchondral cysts
    1 cyst: 1
    More than 1 cyst: 2

    Erosions of the joint's edges
    yes: 1

    Incongruence of the joint's edges
    slight: 1
    increased: 2

    Joint deformity (i.e. dislocated)
    slight: 1
    increased: 2


    NUSS-SCORE (MRI 0-13 points):

    Hemorrhage
    slight: 1
    moderate: 2
    large: 3

    Hemosiderin
    present: 1

    Synovia hypertrophy
    slight: 1
    moderate: 2
    large: 3

    Subchondral cysts/erosion
    1 cyst and partial surface erosion: 1
    > 1 cyst and partial surface erosion: 2
    > 1 cyst and complete surface erosion: 3

    Cartilage defects
    < 50%: 1
    >/= 50%: 2
    complete: 3  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    hemorrhage, hemophilia, hemophil, hemophilic, arthropathia, arthropathy, hemophilic arthropathy, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Wolfgang Hirsch, S Horneff. Hemophilic arthropathy (MRI findings). PedRad [serial online] vol 3, no. 10.
    URL: www.PedRad.info/?search=20031026194110  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Leg-Bones
    or in the region: Leg
    or in the tissue/organ: Bones
    or with the etiology: physical
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Hemophilic arthropathy (MRI findings)
    Wolfgang Hirsch, S Horneff. Hemophilic arthropathy (MRI findings). PedRad [serial online] vol 3, no. 10.
    URL: www.PedRad.info/?search=20031026194110


     

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    Hemophilic arthropathy (MRI findings)
    Other cases by these authors:

    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search S. Horneff in Medline S. Horneff (1)   

    Hemophilic arthropathy (MRI findings)  
     
    Hemophilic arthropathy (MRI findings)
    Wolfgang Hirsch, S Horneff. Hemophilic arthropathy (MRI findings). PedRad [serial online] vol 3, no. 10.
    URL: www.PedRad.info/?search=20031026194110


     

    Which diagnosis have other collegues guessed?


    • Rheumatoid arthritis
      Votes: 2 (11 %)


    • Multifocal bacterial arthritis
      Votes: 0 (0 %)


    • Hemophilic arthropathy
      Votes: 13 (76 %)


    • Arthritis fugax
      Votes: 1 (5 %)


    • Multifocal psoriarthritis
      Votes: 0 (0 %)


    • Neuropathic arthropathy at leprosy
      Votes: 1 (5 %)



        Total answers: 17

     
    Hemophilic arthropathy (MRI findings)
    Wolfgang Hirsch, S Horneff. Hemophilic arthropathy (MRI findings). PedRad [serial online] vol 3, no. 10.
    URL: www.PedRad.info/?search=20031026194110


     

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    Hemophilic arthropathy (MRI findings)
    Wolfgang Hirsch, S Horneff. Hemophilic arthropathy (MRI findings). PedRad [serial online] vol 3, no. 10.
    URL: www.PedRad.info/?search=20031026194110


     




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