Synovitis in hemophilia: preventing, detecting, and treating joint bleeds.
Emérito Carlos Rodríguez MerchánPublished in: Expert review of hematology (2023)
It is essential to prevent, detect and treat hemophilic synovitis, because it indicates that the joint has bled and is at risk of bleeding further. Prophylaxis with standard half life (SHL) factor VIII (FVIII) concentrate is the standard of care for individuals with severe hemophilia A and can also be considered for selected patients with moderate disease. Several years of real-world experience with extended half life (EHL) FVIII, emicizumab, and other drugs in development will be needed to ascertain their final effect on bleeding and its complications. We must look for synovitis in individuals declaring joint pain and in asymptomatic patients, and POC-US is the most reasonable imaging instrument with which to carry out periodic joint screening. Radiosynovectomy, chemical synovectomy, and arthroscopic synovectomy markedly reduce bleeding events.
Keyphrases
- end stage renal disease
- atrial fibrillation
- chronic kidney disease
- healthcare
- newly diagnosed
- high resolution
- chronic pain
- palliative care
- ejection fraction
- pain management
- patient reported outcomes
- prognostic factors
- peritoneal dialysis
- risk factors
- quality improvement
- photodynamic therapy
- spinal cord injury
- fluorescence imaging
- patient reported