Diagnosis and treatment of chronic synovitis in patients with haemophilia: consensus statements from the Italian Association of Haemophilia Centres. (19th December 2021)

• Record Type: Journal Article
• Authors: Di Minno, Matteo Nicola Dario; Napolitano, Mariasanta; Giuffrida, Anna Chiara; Baldacci, Erminia; Carulli, Christian; Boccalandro, Elena; Bruno, Clarissa; Forneris, Eleonora; Ricca, Irene; Passeri, Walter; Martinelli, Marco; Rivolta, Gianna Franca; Solimeno, Luigi Piero; Martinoli, Carlo; Rocino, Angiola; Pasta, Gianluigi
• Other Names: Aru Brigida investigator.; Balestri Elena investigator.; Biasoli Chiara investigator.; Cantori Isabella investigator.; Coluccia Antonella investigator.; Contino Laura investigator.; Coppola Antonio investigator.; Cultrera Dorina investigator.; Daniele Filomena investigator.; Ettorre Cosimo Pietro investigator.; Giordano Paola investigator.; Iannaccaro Piergiorgio investigator.; Lassandro Giuseppe investigator.; Linari Silvia investigator.; Luciani Matteo investigator.; Malcangi Giuseppe investigator.; Mancuso Maria Elisa investigator.; Marchesini Emanuela investigator.; Marino Renato investigator.; Mazucconi Maria Gabriella investigator.; Molinari Angelo Claudio investigator.; Notarangelo Lucia Dora investigator.; Pasca Samantha investigator.; Quintavalle Gabriele investigator.; Radossi Paolo investigator.; Raso Simona investigator.; Sabatino Vincenzo investigator.; Santagostino Elena investigator.; Santoro Cristina investigator.; Scaturro Dalila investigator.; Zanon Ezio investigator.;
• Is Part Of: British journal of haematology. Volume 196:Number 4(2022)
• Page Start: 871
• Page End: 883
• Publication Date: 2021-12-19
• Subjects: haemophilia -- haemophilic arthropathy -- synovitis; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.17919
• Languages: English
• ISSNs: 0007-1048

Abstract

Summary: Although synovitis is recognized as a marker of joint disease activity, its periodic assessment is not included in routine clinical surveillance of patients with haemophilia (PwH). In order to evaluate the current knowledge and to identify controversial issues, a preliminary literature search by the Musculoskeletal Committee of the Italian Association of Haemophilia Centres (AICE) has been conducted. Statements have been established and sent to the Italian AICE members to collect their level of agreement or disagreement by a Delphi process. Thirty‐seven consensus recommendations have been drafted. We found a general agreement on the indication to consider the presence of synovitis as a marker of joint disease activity in PwH. Accordingly, there was agreement on the indication to search for synovitis both in patients reporting joint pain and in asymptomatic ones, recognizing ultrasound as the most practical imaging technique to perform periodic joint screening. Interestingly, after detection of synovitis, there was agreement on the indication to modify the therapeutic approach, suggesting prophylaxis in patients treated on demand and tailoring treatment in patients already under prophylaxis. Whereas the need of an early consultation with a physiotherapist is recommended for PwH affected by chronic synovitis, the exact timing for an orthopaedic surgeon consultation is currently unknown.