ASSESSMENT OF HAEMOPHILIC ARTHROPATHY IN PATIENTS WITH SEVERE HEMOPHILIA USING THE HEMOPHILIA EARLY ARTHROPATHY DETECTION WITH ULTRASOUND (HEAD-US) SCORE AND THE HEMOPHILIA JOINT HEALTH SCORE (HJHS) BY DIFFERENT CAREGIVERS

Abstract

Objective: There are few studies on the assessment of hemophilic arthropathy using the hemophilia early arthropathy detection with ultrasound (HEAD-US) and hemophilia joint health score (HJHS) scores.This study aimed to examine how radiologists and rheumatologists could evaluate hemophilic arthropathy in individuals with severe hemophilia using HEAD- US and HJHS scores simultaneously. Material and Methods: Between 2021 and 2022, 168 joints from 28 individuals with severe hemophilia A and B were investigated at six-month intervals (TP1 and TP2). The HJHS scores of all patients were recorded. The HEAD-US in each hemophilic patient's six joints (elbow, knee, and ankle) were evaluated by radiologists and rheumatologists. Results: The ankle assessment by HEAD-US showed the highest rate (34%) of synovitis by radiologist evaluation at TP1 in patients with an HJHS score of 0. The knee assessment by HEAD-US showed the highest rate (56%) of synovitis and bone damage by rheumatologist evaluation at TP1 in patients with an HJHS score of 0. HEAD-US ankle and knee examinations revealed the highest rate of synovitis (34%) by radiologist evaluation at TP2 in patients with an HJHS score of 0. The HEAD-US knee assessment revealed the highest rate of synovitis (44%) by rheumatologist evaluation at TP2 in patients with an HJHS score of 0. In the assessment of elbow and knee joints, there was a moderate to good correlation between HJHS and HEAD-US scores by different caregivers at different time points (p< 0.05). Conclusion: Our findings indicate that clinicians play a crucial role in the early diagnosis of subclinical hemophilic arthropathy, with HEAD-US scoring conducted by rheumatologists similar to radiologists in severe hemophilia patients without pathology in HJHS scoring.