Advanced haemophilic arthropathy of the elbow

Case contributed by Mohamed Mahmoud Elthokapy


A known patient with hemophilia developed recurrent elbow swelling, pain, and inflammation.

Patient Data

Age: 20 years
Gender: Male

There is marked resorption of articular surfaces, widened joint spaces and gross deformity associated with periarticular soft tissue swelling containing calcific material.

There is marked destruction of articular surfaces, osteochondral loss, and a large heterogeneous joint effusion containing debris and loose bodies, The synovial lining shows hypointense T2 signal due to hemosiderin deposition.

Case Discussion

Hemophilia is a blood disorder caused by a lack of one or more clotting factors and presenting with recurrent hemorrhage. Bleeding occurs in the synovial joints (hemarthrosis) and leads to hyperemia. Blood causes irritation of the synovial lining, synovial hypertrophy, and later on destruction of the articular surfaces with erosion and progressive resorption of bony structures as in this case. Recurrent bleeding within the elbow joint causes hemosiderin deposition seen as low T2 signal.

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