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Hemophilic Arthropathy of the Upper Limb

HÖGH, JORGEN*; LUDLAM, CHRISTOPHER, A.**; MACNICOL, MALCOLM, F.p†

Clinical Orthopaedics and Related Research: May 1987 - Volume 218 - Issue - p 225–231
Section II GENERAL ORTHOPAEDICS: PDF Only
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Little has been written about the effects of hemophilic arthropathy on the function and radiography of the upper limb. Therefore, 14 moderate and 19 severe hemophiliacs between the ages of 10 and 57 years were examined clinically and radiographically. The extent of the arthropathic changes in the shoulders, elbows, wrists, and hands were classified according to the system proposed by the World Federation of Hemophilia. The severity of the arthropathy increased with the age of the patient and with the number of hemarthroses recorded, although the correlation between these parameters was variable. The elbow joints were the site of recognizable arthropathy in 87% of the cases, with a slight preponderance for the nondominant side. The gleno-humeral and wrist joints were affected in a small proportion of patients, although symptoms were rarely experienced. Hemorrhages affecting the hands were uncommon and produced arthropathy infrequently.

* Honorary Registrar, Princess Margaret Rose Orthopaedic Hospital, Fairmilehead Edinburgh and The Royal Infirmary of Edinburgh, Scotland.

** Director, Haemophilia Centre, Royal Infirmary, Edinburgh, United Kingdom.

† Consultant Orthopaedic Surgeon and Senior Lecturer, Department of Orthopaedic Surgery, University of Edinburgh, Edinburgh, United Kingdom.

© Lippincott-Raven Publishers.