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Jhandai M, Choudhry D, Atri SK, Bhardwaj P, Yadav K. Walking ability in adults with severe hemophilia: A cross-sectional study. Clin Hematol Int 2024; 6:84-87. [PMID: 38817696 PMCID: PMC11087000 DOI: 10.46989/001c.94374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 06/01/2024] Open
Abstract
A lack of factor VIII (FVIII) or factor IX (FIX) results in hemophilia, a blood-clotting illness. The mode of inheritance is chromosome X-linked and recessive. The primary symptom of severe hemophilia is spontaneous and recurrent bleeding into joints, muscles, and soft tissues. Unpreventable bleeding may cause arthropathy, chronic discomfort, and muscular atrophy. Therefore, joints' functional loss affects the functional and walking ability. The aim of this study was to determine the walking ability by measuring the 50-m walk test time in severe hemophilic patients, as compared to the normal population. Sixty subjects (males) in the 18-30 year age group were selected and comprised 30 hemophiliacs and 30 in a control group. The 50-m walking ability was measured in seconds. The results showed a normative value of 36.6 sec in the control and 67.2 sec in the hemophilic group. Statistical analysis of the data showed that the walking ability was significantly reduced in the hemophilic group. These normative values illustrate a useful, simple, reproducible, rapid assessment of walking disability in adults with hemophilic arthropathy, and also aid the planning of treatment.
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Affiliation(s)
- Malika Jhandai
- College of PhysiotherapyPandit Bhagwat Dayal Sharma University of Health Sciences
| | - Dimple Choudhry
- College of PhysiotherapyPandit Bhagwat Dayal Sharma University of Health Sciences
| | - Sudhir Kumar Atri
- Medicine DepartmentPandit Bhagwat Dayal Sharma University of Health Sciences
| | - Pankaj Bhardwaj
- College of PhysiotherapyPandit Bhagwat Dayal Sharma University of Health Sciences
| | - Kusum Yadav
- Department of PhysiotherapyJagannath University
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Ibrahiem OA, Thabet AF, Tony SS, Kerollos KMN, Moeen SM. Assessment of quality of life by functional independence score in hemophilic patients: a single-center experience. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2022. [DOI: 10.1186/s43162-022-00160-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Hemophilia is an inherited condition that is caused by the deficiency of clotting factors in the blood. The most common presentations of hemophilia are hemarthrosis and muscle hemorrhage. The severity of the bleeding episodes can vary from mild to severe resulting in pain and swelling of the joints and the muscles. Repeated musculoskeletal bleeding can result in hemophilic arthropathies with subsequent joint degeneration and deformity. Our study aims to clinically assess the quality of life in hemophilic patients in terms of disease severity and morbidity in our community using the Functional Independence Score for Hemophilia (FISH).
Results
Our cross-sectional study which involved 64 hemophilia patients revealed that the most affected joints were the weight-bearing large joints (knees, elbows, ankles) and this was associated with a lower FISH score. While the total FISH score showed a significant positive correlation with the factor activity level, the average FISH score was 21.11 ± 4.5, and the score was slightly lower in severe hemophilia compared to mild-moderate disease.
Conclusion
We concluded that there is a significant decline in the functional ability of hemophilia patients having disease affecting the knee and elbow joints. Moreover, squatting was significantly reduced in patients with severe hemophilia. The quality of patients’ life can be improved by early and regular physiotherapy and regular administration of the prophylactic factor.
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孟 蕾, 庄 金, 孙 雪, 柳 竹, 周 璇, 刘 昊, 周 芳, 李 颖, 孙 竞. [Effect of FVIII doses on joint structure and function in adolescents with severe hemophilia A: mid-term results of a prospective cohort study]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:536-542. [PMID: 33963712 PMCID: PMC8110454 DOI: 10.12122/j.issn.1673-4254.2021.04.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To explore the clinical phenotype and changes in joint structure and function in adolescent patients with severe hemophilia A under different doses of FVIII. OBJECTIVE Forty- three adolescents with severe hemophilia A aged 4-18 years were divided into on-demand group (n=7), low-dose group (FVIII dose of 10-15 U/kg, 2-3 times a week, and ≤30 U/kg a week; n=17), and intermediate-dose group (FVIII dose of 15-20 U/kg, 2-3 times a week, and 45-60 U/kg a week (n=19). The 3 groups were compared for their clinical bleeding phenotype, annual bleeding rate (ABR), annual joint bleeding rate (AJBR), annual the most severe joint bleeding rate, joint imaging scores (ultrasound HEAD-US score and IPSG MRI score), Hemophilia Joint Health Score (HJHS) and Functional Independence Score in Hemophilia (FISH) within 24 months. OBJECTIVE Compared with that in on-demand group, the ABR was significantly reduced in the low- and intermediate-dose groups (P=0.004 and 0.000, respectively), and was reduced by 32.87% in the intermediate-dose group as compared with the low-dose group. The AJBR (P < 0.01) and annual the most severe joint bleeding rate (P < 0.05) also differed significantly among the 3 groups. The number of bleeding episodes increased progressively with time in the on-demand group, remained stable in the low- dose group, and tended to decrease in the intermediate-dose group. The imaging scores of the most severe joints showed lesion progression in all the 3 groups. The ultrasound scores, which increased steadily in the on-demand group, showed significantly lowered increment rates in the low- and intermediate-dose groups (P=0.002 and 0.000, respectively). The MRI scores showed also delayed increment in the low- and intermediate-dose groups as compared with the on-demand group (P=0.041 and 0.000, respectively), and the increment was accelerated in the on-demand and low-dose group but remained stable in the intermediate-dose group. The increment of the HJHS scores was significantly higher in the on-demand group than in the lowand intermediate-dose groups (P=0.003 and 0.000, respectively), and the scores increased at a steady rate in the on-demand group but tended to decrease in the latter two groups. The FISH score was decreased by 0.29±3.09 in the on-demand group but was increased significantly in the low- and intermediate-dose groups compared with the on-demand group (P=0.000). OBJECTIVE In Chinese adolescents with severe hemophilia A, low- and intermediate-dose FVIII prophylaxis, especially at the intermediate dose, is better than on- demand treatment for protecting joint structure and function.
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Affiliation(s)
- 蕾 孟
- 南方医科大学南方医院血液科,广东 广州 510515Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 金木 庄
- 南方医科大学南方医院血液科,广东 广州 510515Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 雪岩 孙
- 南方医科大学南方医院血液科,广东 广州 510515Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 竹琴 柳
- 南方医科大学南方医院血液科,广东 广州 510515Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 璇 周
- 南方医科大学南方医院血液科,广东 广州 510515Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 昊 刘
- 南方医科大学南方医院超声科,广东 广州 510515Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 芳 周
- 南方医科大学南方医院影像诊断科,广东 广州 510515Department of Diagnostic Imaging, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 颖嘉 李
- 南方医科大学南方医院超声科,广东 广州 510515Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 竞 孙
- 南方医科大学南方医院血液科,广东 广州 510515Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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von Mackensen S, Hilberg T, Valentino LA, Kurnik K, Khair K. Validation of the Haemophilia & Exercise Project-Test-Questionnaire (HEP-Test-Q)-An instrument for the assessment of subjective physical functioning in children with haemophilia. Haemophilia 2018; 24:888-895. [PMID: 30004619 DOI: 10.1111/hae.13533] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2018] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Contemporary haemophilia management recommends sport and physical activity in children with haemophilia. Assessment of subjective physical functioning requires standardized and validated instruments. AIMS To adapt and psychometrically test the adult Haemophilia & Exercise Project-Test-Questionnaire (HEP-Test-Q) for children (aged 6-17 years). METHODS In discussion rounds with children, single items of the adult HEP-Test-Q were reformulated to make them understandable without changing the item concept. The validation of the child-adapted version in children with haemophilia (n = 228) included pre-testing with feasibility testing, cognitive interviewing (n = 34), pilot-testing of the revised version in the EIS Study (n = 67) and field-testing in the SO-FIT Study (n = 127). RESULTS Pre-testing revealed a completion time of 8.2 ± 4.1 minutes and children liked the instrument. Cognitive interviews demonstrated that most items were easy to understand; 9 items were reformulated. Pilot-testing demonstrated good psychometric characteristics in terms of reliability (α = .94 Total Score) and validity. Convergent validity testing showed moderate correlations with the Haemo-QoL (r = -.491), but low correlations with the Petrini Score (r = -.293). Known groups' validity revealed significant differences in clinical subgroups; chronic pain (P < .002) and target joints (P < .021). Field-testing confirmed psychometric characteristics; Cronbach's alpha ranged from α = .80 ("endurance") to α = .94 (Total Score). The child-adapted HEP-Test-Q showed moderate correlations with the PedHAL (r = .634, P < .0001) and the Haemo-QoL SF (r = -.575, P < .0001). Known groups' validity testing proved that the HEP-Test-Q could discriminate between clinical subgroups. CONCLUSION The child-adapted HEP-Test-Q is a short, practical and acceptable instrument for the assessment of subjective physical functioning. Outcomes can be compared to adults because item concepts are identical to the adult version.
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Affiliation(s)
- S von Mackensen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Hilberg
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | | | - K Kurnik
- Department of Paediatric Haemostasis, University Children's Hospital, Munich, Germany
| | - K Khair
- Great Ormond Street Hospital for Children NHS Trust, London, UK
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Timmer MA, Gouw SC, Feldman BM, Zwagemaker A, de Kleijn P, Pisters MF, Schutgens REG, Blanchette V, Srivastava A, David JA, Fischer K, van der Net J. Measuring activities and participation in persons with haemophilia: A systematic review of commonly used instruments. Haemophilia 2017; 24:e33-e49. [DOI: 10.1111/hae.13367] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2017] [Indexed: 11/30/2022]
Affiliation(s)
- M. A. Timmer
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht University; The Netherlands
- Physical Therapy Research; Department of Rehabilitation; Physical Therapy Science and Sport; Brain Center Rudolf Magnus; Utrecht University; The Netherlands
| | - S. C. Gouw
- Department of Pediatric Hematology; Academic Medical Center; Amsterdam The Netherlands
| | - B. M. Feldman
- Division of Rheumatology; Department of Paediatrics; The Hospital for Sick Children; Institute of Health Policy, Management and Evaluation; Dalla Lana School of Public Health; University of Toronto; Toronto ON Canada
| | - A. Zwagemaker
- Department of Pediatric Hematology; Academic Medical Center; Amsterdam The Netherlands
| | - P. de Kleijn
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht University; The Netherlands
- Physical Therapy Research; Department of Rehabilitation; Physical Therapy Science and Sport; Brain Center Rudolf Magnus; Utrecht University; The Netherlands
| | - M. F. Pisters
- Physical Therapy Research; Department of Rehabilitation; Physical Therapy Science and Sport; Brain Center Rudolf Magnus; Utrecht University; The Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care; Julius Health Care Centers; Utrecht The Netherlands
| | - R. E. G. Schutgens
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht University; The Netherlands
| | - V. Blanchette
- Department of Pediatrics; Division of Hematology/Oncology Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - A. Srivastava
- Department of Haematology; Christian Medical College; Vellore India
| | - J. A. David
- Department of Physical Medicine and Rehabilitation; Christian Medical College; Vellore India
| | - K. Fischer
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht University; The Netherlands
| | - J. van der Net
- Department of Child Development and Exercise; University Medical Center Utrecht and Children's Hospital; Utrecht University The Netherlands
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Fischer K, Poonnoose P, Dunn AL, Babyn P, Manco-Johnson MJ, David JA, van der Net J, Feldman B, Berger K, Carcao M, de Kleijn P, Silva M, Hilliard P, Doria A, Srivastava A, Blanchette V. Choosing outcome assessment tools in haemophilia care and research: a multidisciplinary perspective. Haemophilia 2016; 23:11-24. [DOI: 10.1111/hae.13088] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2016] [Indexed: 01/23/2023]
Affiliation(s)
- K. Fischer
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht The Netherlands
| | - P. Poonnoose
- Department of Orthopaedics; Christian Medical College; Vellore Tamil Nadu India
| | - A. L. Dunn
- Division of Hematology and Oncology; Nationwide Children's Hospital and The Ohio State University; Columbus OH USA
| | - P. Babyn
- Department of Medical Imaging; University of Saskatchewan and Saskatoon Health Region Royal University Hospital; Saskatoon SK Canada
| | - M. J. Manco-Johnson
- Section of Hematology/Oncology/Bone Marrow Transplantation; Department of Pediatrics; University of Colorado Anschutz Medical Campus and Children's Hospital; Aurora CO USA
| | - J. A. David
- Department of PMR; Christian Medical College; Vellore Tamil Nadu India
| | - J. van der Net
- Child Health Services; Child Development and Exercise Center; University Medical Center and Children's Hospital; Utrecht The Netherlands
| | - B. Feldman
- Division of Rheumatology; Department of Paediatrics and Child Health Evaluative Sciences; Research Institute; Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - K. Berger
- Division of Haematology/Oncology; University Hospital of Munich; Munich Germany
| | - M. Carcao
- Division of Haematology/Oncology; Department of Paediatrics and Child Health Evaluative Sciences; Research Institute; Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - P. de Kleijn
- Department of Rehabilitation, Nursing Science and Sports, and Van Creveldkliniek; University Medical Center Utrecht; Utrecht The Netherlands
| | - M. Silva
- Department of Orthopaedic Surgery; Orthopaedic Institute for Children; David Geffen School of Medicine at UCLA; Los Angeles CA USA
| | - P. Hilliard
- Department of Rehabilitation; Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - A. Doria
- Department of Diagnostic Imaging; Research Institute; Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - A. Srivastava
- Department of Haematology; Christian Medical College; Vellore Tamil Nadu India
| | - V. Blanchette
- Division of Haematology/Oncology; Department of Paediatrics and Child Health Evaluative Sciences; Research Institute; Hospital for Sick Children; University of Toronto; Toronto ON Canada
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Abdel Ghany HM, Hassab HMA, El-Noueam KI. Hemophilic arthropathy: clinical, radiologic, and functional evaluation: a single-center experience in a limited resource country. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2016. [DOI: 10.4103/1110-161x.177425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gupta S, Garg K, Singh J. Assessment of Musculoskeletal Function and its Correlation with Radiological Joint Score in Children with Hemophilia A. Indian J Pediatr 2015; 82:1101-6. [PMID: 25947262 DOI: 10.1007/s12098-015-1759-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 04/01/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the functional independence of children with hemophilia A and its correlation to radiological joint score. METHODS The present cross sectional study was conducted at SPMCHI, SMS Medical College, Jaipur, India. Children in the age group of 4-18 y affected with severe, moderate and mild hemophilia A and with a history of hemarthrosis who attended the OPD, emergency or got admitted in wards of SPMCHI, SMS Medical College were examined. Musculoskeletal function was measured in 98 patients using Functional Independence Score in Hemophilia (FISH) and index joints (joints most commonly affected with repeated bleeding) were assessed radiologically with plain X rays using Pettersson score. RESULTS The mean FISH score was 28.07 ± 3.90 (range 17-32) with squatting, running and step climbing as most affected tasks. The mean Pettersson score was 3.8 ± 3.2. A significant correlation was found between mean Pettersson score and FISH (r = -0.875, P < 0.001) with knee and elbow having r = -0.810 and -0.861 respectively, but not in case of ankle with r = -0.420 (P 0.174). CONCLUSIONS The FISH and radiological joint (Pettersson's) scores may be extremely useful in the clinical practice in the absence of magnetic resonance imaging (MRI), which is considered very sensitive to detect early joint damage, but at a cost that makes it relatively inaccessible. FISH seems to be a reliable tool for assessment of functional independence in patients with hemophilia A.
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Affiliation(s)
- Samriti Gupta
- Department of Pediatric Medicine, S.M.S. Medical College, Jaipur, India.
- , Ward no. 3, Khushinagar, Tehsil Nurpur, Distt. Kangra, Himachal Pradesh, 176202, India.
| | - Kapil Garg
- Department of Pediatric Medicine, S.M.S. Medical College, Jaipur, India
| | - Jagdish Singh
- Department of Pediatric Medicine, S.M.S. Medical College, Jaipur, India
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Gupta AK, Jana M. Hemophilia Management and Follow-up: Role of Radiological and Functional Assessment of the Disease Severity. Indian J Pediatr 2015; 82:1084-5. [PMID: 26400035 DOI: 10.1007/s12098-015-1882-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 08/10/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Arun Kumar Gupta
- Department of Radio-diagnosis, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Manisha Jana
- Department of Radio-diagnosis, All India Institute of Medical Sciences, New Delhi, 110029, India
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10
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Srivastava A. Haemophilia care - beyond the treatment guidelines. Haemophilia 2014; 20 Suppl 4:4-10. [DOI: 10.1111/hae.12429] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2014] [Indexed: 02/05/2023]
Affiliation(s)
- A. Srivastava
- Department of Haematology; Christian Medical College; Vellore India
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11
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Gupta V, Sandeep HS, Rai A, Shukla J. Functional and radiological assessment of arthropathy in Indian children with haemophilia. Haemophilia 2013; 19:e373-5. [DOI: 10.1111/hae.12215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2013] [Indexed: 12/01/2022]
Affiliation(s)
- V. Gupta
- Department of Pediatrics; Institute of Medical Sciences; Banaras Hindu University; Varanasi India
| | - H. S. Sandeep
- Department of Pediatrics; Institute of Medical Sciences; Banaras Hindu University; Varanasi India
| | - A. Rai
- Faculty of Science; Centre for Genetic Disorders; Banaras Hindu University; Varanasi India
| | - J. Shukla
- Department of Pathology; Institute of Medical Sciences; Banaras Hindu University; Varanasi India
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12
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POONNOOSE P, KESHAVA S, GIBIKOTE S, FELDMAN BM. Outcome assessment and limitations. Haemophilia 2012; 18 Suppl 4:125-30. [DOI: 10.1111/j.1365-2516.2012.02837.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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13
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HASSAN TH, BADR MA, FATTAH NRA, BADAWY SM. Assessment of musculoskeletal function and mood in haemophilia A adolescents: a cross-sectional study. Haemophilia 2011; 17:683-8. [DOI: 10.1111/j.1365-2516.2010.02475.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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14
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Hassan TH, Badr MA, El-Gerby KM. Correlation between musculoskeletal function and radiological joint scores in haemophilia A adolescents. Haemophilia 2011; 17:920-5. [PMID: 21371193 DOI: 10.1111/j.1365-2516.2011.02496.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The functional independence score in haemophilia (FISH) is a performance-based instrument used to assess musculoskeletal function in patients with haemophilia. We aimed to evaluate the functional independence of haemophilia A adolescents and its correlation to radiological joint scores. A cross-sectional study was carried out on 50 adolescent haemophilia A patients. Musculoskeletal function was assessed using the FISH and individual joints were assessed radiologically using the Pettersson score and MRI scale. The mean age of our patients was 16 ± 1.1 with a mean FISH of 23.32 ± 4.69 (range 13-28) and a mean Pettersson score of 2.32 ± 3.09 (range 0-13) for the knees, 1.86 ± 2.67 (range 0-11) for ankles and 1.42 ± 2.17 (range 0-10) for elbows. The mean MRI score for the knees was 3.92 ± 2.74 (range 0-10) while that for ankles was 3.16 ± 2.64 (range 0-10) and for elbows was 2.34 ± 2.63 (range 0-10). There was highly significant correlation between both radiological joint scores and FISH and between degree of factor VIII deficiency and each of FISH, Pettersson score and MRI score. MRI was superior to conventional radiography in detection of subchondral cyst formation and erosions at joint margins. Given the highly significant correlation with both radiological joint scores, FISH appears to be a reliable tool for assessment of functional independence in adolescents with haemophilia A. MRI is more sensitive than conventional radiography in detection of early joint abnormalities.
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Affiliation(s)
- T H Hassan
- Department of Pediatrics, Zagazig University, Egypt.
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