Researchers reported that the use of musculoskeletal ultrasound during routine joint evaluations has a significant impact on how physicians formulate their physical therapy plans for patients with hemophilia-associated arthropathy. Their study is published in BMC Musculoskeletal Disorders.

Hemophilia causes bleeding into the joints, which is a major source of morbidity. The extent of hemophilic arthropathy depends largely on the number of joint bleeds per year, irrespective of factor replacement strategies. 

“Long-term preservation of joint health is an unmet need,” the authors of the study wrote. “For timely and meaningful management of [hemophilic arthropathy], it is critical to assess the extent and progression of [hemophilic arthropathy] regularly.” 


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Because magnetic resonance imaging (MRI) is typically unavailable during follow-up evaluations, musculoskeletal ultrasound has emerged as a powerful tool in assessing hemarthrosis. Studies indicate that musculoskeletal ultrasound findings correlate with those identified on MRI scans. It can also detect the extent of intra-articular bleeding. 

Read more about hemophilia etiology 

The authors of the study hence sought to assess the impact of musculoskeletal ultrasound during routine joint evaluations in patients with hemophilia. They recruited 42 adult patients with hemophilia A or B at 3 hemophilia treatment centers between May 2016 and April 2019. Patients must have possessed documented evidence of at least 1 arthropathic joint. 

Physicians performed a musculoskeletal ultrasound scan on all patients during follow-up visits, in addition to their usual tests. At the end of each visit, detailed management plans were recorded. Physicians were asked to document if the musculoskeletal ultrasound scan results influenced their treatment plans in any way. 

“This study found that [musculoskeletal ultrasound], when incorporated into comprehensive hemophilia care during routine follow-up visits, was utilized most frequently to inform joint-specific [physical therapy] plans, rather than leading to adjustments in hemostatic support,” the authors of the study wrote. 

Future studies assessing the benefits of treatment plans informed by musculoskeletal ultrasound findings are needed to understand their overall impact on joint health outcomes.

Reference

Gallastegui N, Steiner B, Aguero P, et al. The role of point-of-care musculoskeletal ultrasound for routine joint evaluation and management in the hemophilia clinic — a real world experienceBMC Musculoskelet Disord. 2022;23(1):1111. doi:10.1186/s12891-022-06042-w