Children with hemophilia (HEM) have reduced cortical bone density in the radius and the tibia, according to a study published in Haemophilia. 

Hemophilia is a disorder that predisposes an individual to experiencing spontaneous bleeding into the joints and muscles. Osteoporosis is a condition in which reduced bone strength increases the risk of fractures. Studies indicate that children with hemophilia are at a higher risk of suffering from low bone mineral density in the spine compared with healthy children. 

“There is a scarcity of information in the English literature on long bone density analysis with the use of quantitative ultrasound in children living with hemophilia,” the authors wrote. 

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They sought to compare cortical long bone density in children with hemophilia and healthy controls. The study focused their efforts on investigating bone mineral density in two bones: the radius and tibia. They recruited 91 children with hemophilia ranging from 6 to 15 years of age; the same number of sex- and age-matched controls were selected from nearby schools. 

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The research team used quantitative ultrasound to estimate bone density. They measured the speed of sound, which is the shortest propagation time of the signal between the transmitter and the receiver; in this study, the tibia and the radius were measured. In addition, they performed an evaluation of the elbow, knee, and ankle joints using the Hemophilia Joint Health Score 2.1. 

The results revealed that children with hemophilia had significantly poorer cortical bone density of the radius and the tibia compared with the healthy control group. In addition, children with hemophilia had higher total Hemophilia Joint Health Score 2.1 scores, which correlated with hemophilia disease severity, compared with healthy peers.

“It is recommended that children with hemophilia engage in more physical activity, which may enhance muscle strength and eventually preserve bone strength,” the authors wrote. “Upper and lower joint involvement may be important indicators of bone health and should be considered for monitoring and promoting the bone health status in children with hemophilia.” 


Tlacuilo-Parra A, Soto-Padilla J, Toro-Castro L, Gutierrez-Hermosillo V, Guevara-Gutierrez E. Diminished cortical bone density of long bones among children with haemophilic arthropathyHaemophilia. 2022;10.1111/hae.14682. doi:10.1111/hae.14682