Power Doppler sonography in the diagnosis of hemophilic synovitis – a promising tool

Background: Recurrent hemarthroses in hemophilia results in synovitis and joint arthropathy. Primary prophylaxis when universally instituted at current doses can prevent joint deterioration but is expensive. Alternatively, the selective implementation of prophylaxis would require a more sensitive to...

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Bibliographic Details
Published in:Journal of thrombosis and haemostasis 2008-12, Vol.6 (12), p.2055-2061
Main Authors: ACHARYA, S. S., SCHLOSS, R., DYKE, J. P., MINTZ, D. N., CHRISTOS, P., DIMICHELE, D. M., ADLER, R. S.
Format: Article
Language:English
Subjects:
Adolescent
Adult
arthropathy
Child
Diagnostic Imaging - methods
Diagnostic Imaging - standards
Hemarthrosis - complications
hemophilia
Hemophilia A - complications
Humans
joint disease
Joints - diagnostic imaging
Joints - pathology
Magnetic Resonance Imaging
MRI
power Doppler sonography
synovitis
Synovitis - diagnosis
Synovitis - diagnostic imaging
Ultrasonography, Doppler - economics
Ultrasonography, Doppler - methods
Ultrasonography, Doppler - standards
Young Adult
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Summary:Background: Recurrent hemarthroses in hemophilia results in synovitis and joint arthropathy. Primary prophylaxis when universally instituted at current doses can prevent joint deterioration but is expensive. Alternatively, the selective implementation of prophylaxis would require a more sensitive tool for detecting synovitis than possible with clinical surveillance or plain radiographs. Magnetic resonance imaging (MRI) is such a tool and is utilized for the evaluation of hemophilic joint disease (HJD). However, it is expensive, and requires sedation in younger children precluding its utility for monitoring of synovitis. Ultrasonography (USG) with power Doppler (USG‐PDS) has been utilized to detect and quantitate synovial vascularity in other arthritides and could provide an equally effective but less costly tool for HJD, particularly in children who would not require sedation. Objectives: To determine whether USG‐PDS is comparable to MRI in the evaluation of hemophilic synovitis. Patients: A prospective cohort of 31 subjects including 33 joints (knees, elbows, ankles) underwent dynamic contrast enhanced (DCE)‐MRI and USG‐PDS. Results: USG‐PDS measurements of synovial thickness(r = 0.70, P 
ISSN:1538-7933
1538-7836
1538-7836
DOI:10.1111/j.1538-7836.2008.03160.x