Physical exam, ultrasound needed to monitor recovery in joint bleed in patients with bleeding disorders

There does not appear to be a standard recover time after a joint bleed in patients with bleeding disorders, with different recovery times noted when physical examination or ultrasound are used to monitor, according to a study.

In this retrospective cohort study, joint bleeds in elbows, knees, and ankles of people with hemophilia or Von Willebrand disease who visited the Van Creveldkliniek between 2016 and 2021 were analyzed. Physical examination and ultrasound were used to assess the bleeds and patients were treated according to international treatment guidelines. Follow-up examinations were done until patients fully recovered.

There were 30 joint bleeds in 26 patients included. There was a median recover time of 1 month (range 0.3-5 months), however, 47% of joint bleeds required more than 1 month to heal. In 27% of bleeds, the moment of recovery was different based on physical examination and ultrasound.

“Both persistent abnormalities at physical examination in joints with normalized ultrasounds and persistent ultrasound findings in clinically recovered joints occurred,” the authors wrote.

Reference
van Leeuwen FHP, Fischer K, Foppen W, et al. Monitoring recovery of joints after bleeding: Physical examination and ultrasound are complementary. Haemophilia. 2023;doi: 10.1111/hae.14791. Epub ahead of print. PMID: 37078246.