Hematology Department, "Dr. Gaudencio González Garza" General Hospital, High Specialty Medical Unit, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Gac Med Mex. 2022;158(1):11-15. doi: 10.24875/GMM.M22000634.
Joint ultrasound examination using the HEAD-US method in the detection of early arthropathy is poorly studied in our country.
To compare the clinical and ultrasound evaluation of the joints in haemophilia.
Longitudinal, prospective and descriptive study with paediatric patients with haemophilia A and B evaluated with the HJHS 2.1 scale and ultrasound with a linear transducer of 8 to 12 MHz. Elbows, knees and ankles joints were evaluated bilaterally, with HEAD-US protocol.
69 paediatric patients were included of which 48 with severe haemophilia A (weight: 40.1 kg). On the HJHS scale, a greater involvement was observed in the left knee (0.49), and less in the right ankle (0.05). With the HEAD-US scale, the most affected was the right knee (0.78). There is a significant relationship in the involvement of the right knee evaluated with the HEAD-US scale in the presence of inhibitor.
Weight above the 50 percentile is an independent risk factor for joint bleeding complications, while age and type of haemophilia do not appear to be related. The HEAD-US method is a useful and accessible tool for early detection of arthropathy and hemarthrosis.
在我国，使用 HEAD-US 方法进行关节超声检查以检测早期关节病的研究甚少。
比较血友病患者的关节临床和超声评估。
采用纵向、前瞻性和描述性研究方法，对接受 HJHS 2.1 量表和 8-12MHz 线性探头超声检查的甲型和乙型血友病儿科患者进行评估。采用 HEAD-US 方案对双侧肘、膝和踝关节进行评估。
共纳入 69 名儿科患者，其中 48 名患有严重甲型血友病（体重：40.1kg）。在 HJHS 量表上，左侧膝关节（0.49）的受累程度更大，而右侧踝关节（0.05）的受累程度更小。在 HEAD-US 量表上，右侧膝关节的受累程度最高（0.78）。在存在抑制剂的情况下，用 HEAD-US 量表评估右膝关节的受累程度存在显著相关性。
体重超过第 50 百分位数是关节出血并发症的独立危险因素，而年龄和血友病类型似乎与关节病无关。HEAD-US 方法是一种有用且易于获得的早期检测关节病和关节积血的工具。
