Assessment of Hemophilic Arthropathy by Ultrasound: Where Do We Stand?

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Abstract

[Indexed for MEDLINE] 10. Expert Rev Hematol. 2024 Oct;17(10):713-721. doi: 10.1080/17474086.2024.2396617. Epub 2024 Sep 8. Optimizing long-term joint health in the treatment of hemophilia. Gualtierotti R(1)(2), Giachi A(2), Suffritti C(1), Bedogni L(3), Franco F(3), Poggi F(4), Mascetti S(5), Colussi M(5), Ahmetovic D(5), Begnozzi V(1), Boccalandro EA(1), Solimeno LP(6), Peyvandi F(1)(2). Author information: (1)Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy. (2)Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy. (3)Dipartimento di Scienze Fisiche, Informatiche e Matematiche, Università degli Studi di Modena e Reggio Emilia, Modena, Italy. (4)Institute for Cognitive Sciences and Technologies (ISTC), National Research Council (CNR), Bologna, Italy. (5)Department of Computer Science, Università degli Studi di Milano, Milan, Italy. (6)Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Orthopaedic Surgery and Traumatology, Milan, Italy. INTRODUCTION: The improved quality of care and increased drug availability have shifted the goal of treating people with hemophilia from life-threatening bleeding prevention to joint health preservation and quality of life amelioration. Many tools are now available to the clinician in order to optimize the management of hemophilic arthropathy. AREAS COVERED: This paper reviews the pivotal role of ultrasound evaluation in early detection of joint bleeding and differential diagnosis of joint pain, with a focus on the feasibility of a long-term monitoring of joint health through the use of artificial intelligence and telemedicine. The literature search methodology included using keywords to search in PubMed and Google Scholar, and articles used were screened by the coauthors of this review. EXPERT OPINION: Joint ultrasound is a practical point-of-care tool with many advantages, including immediate correlation between imaging and clinical presentation, and dynamic evaluation of multiple joints. The potential of telemedicine care, coupled with a point-of-care detection device assisted by artificial intelligence, holds promises for even earlier diagnosis and treatment of joint bleeding. A multidisciplinary approach including early intervention by physical medicine and rehabilitation (PMR) physicians and physiotherapists is crucial to ensure the best possible quality of life for the patient. DOI: 10.1080/17474086.2024.2396617