Haemophilic arthropathy

Case contributed by Dr Andrew Dixon

Presentation

Ankle pain. Known history of hemophilia.

Patient Data

Age: 35 years
Gender: Male
x_ray

Osteoarthritis of posterior subtalar joint, with otherwise near-normal appearance of all other joint spaces. There is soft-tissue density material distending the anterior and posterior tibiotalar joint recesses.

mri

There is marked synovial proliferation at the ankle and posterior subtalar joints which is markedly hypointense on all sequences. There is some contrast enhancement consistent with synovitis. There is marrow edema within the talus and calcaneum and degererative disease of the posterior subtar joint.

Case Discussion

Anterior and posterior ankle soft-tissue density corresponding to the synovial proliferation on MRI. Plain film shows minimal osseous changes despite the marked synovial proliferation seen on MRI.

This patient had known hemophilia and the features are consistent with haemophilic arthropathy with hemosiderin stained proliferative synovitis due to repated episodes of hemarthrosis.

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