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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Hemophilia MRI

Introduction

Overview

Overview

MRI may be helpful in the diagnosis of hemophilia. Findings on MRI suggestive of hemophilic arthropathy include effusion, synovial hypertrophy, erosion, subchondral cyst, cartilage loss, osteonecrosis, fibrocartilage tear, ligament tear, loose body.

MRI

MRI

Additive European MRI scoring system

The additive European MRI scoring system[1]

Type of change Score

Subchondral cysts

  • Present in at least one bone
  • Present in at least two bones
  • More than three cysts in at least one bone
  • More than three cysts in at least two bones
  • Largest size > 4 mm in at least one bone
  • Largest size > 4 mm in at least two bones
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1

Irregularity/erosion of subchondral cortex

  • Present in at least one bone
  • Present in at least two bones
  • Involves more than half of joint surface in at least one bone
  • Involves more than half of joint surface in at least two bones
  • 1
  • 1
  • 1
  • 1

Chondral destruction

  • Present in at least one bone
  • Present in at least two bones
  • Full-thickness defect in at least one bone
  • Full-thickness defect in at least two bones
  • Full-thickness defect involves more than one-third of joint surface in at least one bone
  • Full-thickness defect involves more than one-third of joint surface in at least two bones
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
Effusion/hemarthrosis
  • Absent = 0
  • Equivocal = 1
  • Small = 2
  • Moderate = 3
  • Large = 4
Synovial hypertrophy
  • Absent = 0
  • Equivocal = 1
  • Small = 2
  • Moderate = 3
  • Large = 4
Hemosiderin
  • Absent = 0
  • Equivocal = 1
  • Small = 2
  • Moderate = 3
  • Large = 4

Progressive Denver MRI scoring system

The progressive Denver MRI scoring system[2]

Type of change Findings and Score
Effusion
  • Absent = 0
  • Small = 1
  • Moderate = 2
  • Large = 3
Hemarthrosis
  • Absent = 0
  • Small = 1
  • Moderate = 2
  • Large = 3
Synovial hyperplasia
  • Absent = 0
  • Small = 4
  • Moderate = 5
  • Large = 6
Hemosiderin
  • Absent = 0
  • Small = 4
  • Moderate = 5
  • Large = 6
Erosion
  • Absent = 0
  • Partial-surface erosion = 7
  • Full-surface erosion = 8
Subchondral cyst
  • Absent = 0
  • 1 cyst = 7
  • >1 cyst = 8
Cartilage loss
  • Absent = 0
  • >50% loss = 9
  • ≥ 50% loss = 10
MRI of the right Knee showing hemophilic arthropathy with moderate joint effusion, decreased joint space, subchondral erosions and cystic changes, cartilage loss, the synovium is thickened with multifocal low signal intensity and the intercondylar notch is widened with erosive changes. The intercondylar notch is irregular and wide. .Source: Case courtesy of Dr Abdallah Al Khateeb , Radiopaedia.org, rID: 45521

Ancillary findings of Denver MRI scale[2]

Type of change Finding
Effusion
  • Absent
  • Present
Osteonecrosis
  • Absent
  • Present
Fibrocartilage tear
  • Absent
  • Present
Ligament tear
  • Absent
  • Present
Loose body
  • Absent
  • Present
References

References

  1. ↑ Lundin B, Pettersson H, Ljung R (July 2004). “A new magnetic resonance imaging scoring method for assessment of haemophilic arthropathy”. Haemophilia. 10 (4): 383–9. doi:10.1111/j.1365-2516.2004.00902.x. PMID 15230954.
  2. ↑ 2.0 2.1 Nuss R, Kilcoyne RF, Geraghty S, Shroyer AL, Rosky JW, Mawhinney S, Wiedel J, Manco-Johnson M (May 2000). “MRI findings in haemophilic joints treated with radiosynoviorthesis with development of an MRI scale of joint damage”. Haemophilia. 6 (3): 162–9. PMID 10792474.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]; Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[3]