Magnetic resonance imaging and ultrasound evaluation of "healthy" joints in young subjects with severe haemophilia A. (18th March 2013)

• Record Type: Journal Article
• Authors: Di Minno, M. N. D.; Iervolino, S.; Soscia, E.; Tosetto, A.; Coppola, A.; Schiavulli, M.; Marrone, E.; Ruosi, C.; Salvatore, M.; Di Minno, G.
• Is Part Of: Haemophilia. Volume 19:Number 3(2013:May)
• Page Start: e167
• Page End: e173
• Publication Date: 2013-03-18
• Subjects: Hemophilia -- Periodicals; 616.1572005
• DOI: 10.1111/hae.12107
• Languages: English
• ISSNs: 1351-8216

Abstract

<abstract abstract-type="main" id="hae12107-abs-0001"> <title>Summary</title> <p>Magnetic resonance imaging (MRI) and ultrasonography (US) are increasingly used in haemophilia A (HA) to detect early joint changes. A total of 40 clinically asymptomatic joints, never involved by bleeding events ["healthy joints" (HJ)], were evaluated by MRI and, in parallel, by US in 20 young subjects with severe HA (22.45 ± 2.72 years old; no history of arthritides, of viral infections or of inhibitors against factor VIII). The same joints were evaluated in 20 matched non‐haemophilic (no‐HA) subjects (mean age 23.90 ± 2.31 years, <italic>P </italic>= 0.078 vs. HA subjects). US images were obtained with specific probe positions according to validated procedures. A validated US score and progressive (P‐MRI) and additive (A‐MRI) MRI scores were employed for data collection and analysis. The US score was higher in HA than in no‐HA subjects (3.40 ± 1.72 vs. 0.80 ± 1.10, <italic>P </italic>< 0.001). Taking into account only moderate/severe alterations, joint effusion was found in 55% of HA and in 5% of no‐HA joints (<italic>P </italic>< 0.001); synovial hypertrophy was found in 20% of HA and in none of the no‐HA joints; cartilage erosion was found in 30% of HA and in none of no‐HA joints. MRI examinations confirmed these findings and the US score correlated with the A‐MRI (<italic>r</italic> = 0.732, <italic>P </italic>< 0.001) and with the P‐MRI (<italic>r</italic> = 0.598, <italic>P </italic>< 0.001) scores. MRI and US data significantly correlated as to effusion (<italic>r</italic> = 0.819, <italic>P </italic>= 0.002), synovial hypertrophy (<italic>r</italic> = 0.633, <italic>P </italic>= 0.036) and cartilage erosion (<italic>r</italic> = 0.734, <italic>P </italic>= 0.010). Despite inherent limitations, joint US examination identified subclinical abnormalities of HJ in young subjects with severe HA.</p> </abstract>