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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