What is the role of radiologic interventions in the treatment of hemophilia?

Updated: Sep 27, 2019
  • Author: Lars J Grimm, MD, MHS; Chief Editor: Felix S Chew, MD, MBA, MEd  more...
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MRI is used to detect early hemophilic disease and to help direct the appropriate therapy.

Radioactive injections into joints (radiosynoviorthesis) can control hemorrhage. This treatment was initially used in cases of juvenile rheumatoid arthritis. Subsequently, radiosynoviorthesis was shown to be effective in reducing bleeding and effusion in selected cases of hemophilic arthropathy.

Imaging may aid in needle placement for surgical total joint replacement, which is a valuable treatment for end-stage hemophilic disease. Soft-tissue pseudocysts may be drained percutaneously (with adequate factor replacement during the procedure).

According to data from 130 hemophilia treatment centers enrolled in the Universal Data Collection (UDC) program from 2000 to 2010, there was a 5.6% decrease in  invasive orthopedic interventions in patients with hemophilia. [2]

Special concerns

Radionuclide synovectomy has a good record for low complication rates; however, there remains concern that the radiation exposure in young children could lead to radiation necrosis or tumor induction.

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