Hemophilic Arthropathy: Extraarticular Lesions



- Discussion:
    - extraarticular bleeding may involve muscles, nerves, blood vessels, and even bones;
    - slowly expanding hematoma will interfere w/ function & perfusion of surrounding tissues;
    - intramuscular hematomas that fail to resorb quickly lead to fibrosis, contracture, cyst formation, or myositis ossificans;
          - bleeding into the calf muscles may cause a severe equinus deformity;
          - bleeding into sheath of the iliacus muscle frequently causes paralysis of femoral nerve & flexion contracture of the hip;
          - bleeding into soft tissues of forearm may produce ischemic paralysis and Volkmann's contracture;
    - hemophilic pseudotumor
          - results from subperiosteal hemorrhage leading to bone destruction & new bone formulation leading to formation of large cystic mass;
         - w/ improved coagulation therapy, pseudotumors are less frequently seen;
         - treatment involves radical excision or amputation



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, August 22, 2012 12:40 pm