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previously visited 16 YEAR OLD MALE WITH RECURRENT KNEE SWELLING Random Case
Authored By: Faculty and residents Children's Hospital, Radiologist, Children's Health System, Birmingham, Alabama., USA.
Patient: 16 year old male
History: 16 year old male with recurrent knee swelling.
Images:small[medium]largeas-submittedimages only

Fig. 1: Widening of the intercondylar notch, joint space narrowing and marginal osteophytes

Fig. 2: Hemarthrosis
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Findings:

Hemarthrosis
Widening of the intercondylar notch
Joint space narrowing
Marginal osteophytes

DDx:

Hemopheliac arthrosis
Juvenile rheumatoid/idiopathic arthritis

Diagnosis: Hemopheliac arthrosis
Discussion:

Hemarthrosis most common in hinge joints, e.g. knee, elbow, ankle.
Chronic synovitis develops from repeated intra-articular hemorrhages.
Thickened synovium produces marginal erosions.
Multiple subchondral cysts may develop secondary to intraosseous hemorrhage.

Christmas disease is indistinguishable except milder.

Females can develop hemophilia if hemophiliac male marries female carrier.

X-ray changes due to synovial proliferation and hyperemia.
Widening of the intercondylar notch of the femur.
Chronic hyperemia produces enlargement of epiphyses.
Especially medical condyle.
Secondary trabeculae are resorbed leaving linear striations in the bone.
Sometimes hemosiderin in soft tissues may make them appear dense.

From the increased blood to the epiphyses, the epiphyses may appear too early, grow too large, and fuse early.

Juvenile rheumatoid arthritis may simulate hemophilia changes in bone
JRA occurs more often in females.

References: LearningRadiology.com
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Additional Details:

Case Number: 20140310Last Updated: 10-30-2008
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Anatomy: Skeletal System   Pathology: Hematological
Modality: Conventional RadiographAccess Level: Readable by all users
Keywords: hemophelia
Case has been viewed 448 times.

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