Hemophiliac arthritis

  

• Christmas disease is indistinguishable except milder
   
• Females can develop hemophilia if hemophiliac male marries female carrier
   
• Hemarthrosis most common in hinge joints, e.g. knee, elbow, ankle
• Chronic synovitis develops from repeated intra-articular hemorrhages
• Thickened synovium produces marginal erosions
• Multiple subchondral cysts may develop secondary to intraosseous hemorrhage
   
• X-ray

There is widening of the interconylar notch, accentuation of the
trabeculae and enlargement of the medial epicondyle

• X-ray changes due to synovial proliferation and hyperemia
• Widening of the intercondylar notch of the femur
• Chronic hyperemia produces enlargement of epiphyses
  • Especially medical condyle
• Secondary trabeculae are resorbed leaving linear striations in the bone
• Sometimes hemosiderin in soft tissues may make them appear dense
   

• From the increased blood to the epiphyses, the epiphyses may appear too early, grow too large, and fuse early
   
• Juvenile rheumatoid arthritis may simulate hemophilia changes in bone
  • JRA occurs more often in females