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优化血友病治疗中的长期关节健康。

Optimizing long-term joint health in the treatment of hemophilia.

机构信息

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy.

Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.

出版信息

Expert Rev Hematol. 2024 Oct;17(10):713-721. doi: 10.1080/17474086.2024.2396617. Epub 2024 Sep 8.

Abstract

INTRODUCTION

The improved quality of care and increased drug availability have shifted the goal of treating people with hemophilia from life-threatening bleeding prevention to joint health preservation and quality of life amelioration. Many tools are now available to the clinician in order to optimize the management of hemophilic arthropathy.

AREAS COVERED

This paper reviews the pivotal role of ultrasound evaluation in early detection of joint bleeding and differential diagnosis of joint pain, with a focus on the feasibility of a long-term monitoring of joint health through the use of artificial intelligence and telemedicine. The literature search methodology included using keywords to search in PubMed and Google Scholar, and articles used were screened by the coauthors of this review.

EXPERT OPINION

Joint ultrasound is a practical point-of-care tool with many advantages, including immediate correlation between imaging and clinical presentation, and dynamic evaluation of multiple joints. The potential of telemedicine care, coupled with a point-of-care detection device assisted by artificial intelligence, holds promises for even earlier diagnosis and treatment of joint bleeding. A multidisciplinary approach including early intervention by physical medicine and rehabilitation (PMR) physicians and physiotherapists is crucial to ensure the best possible quality of life for the patient.

摘要

简介

随着医疗护理质量的提高和药物供应的增加,治疗血友病患者的目标已经从预防危及生命的出血转变为保护关节健康和提高生活质量。现在有许多工具可供临床医生使用,以优化血友病性关节病的管理。

涵盖领域

本文回顾了超声评估在早期检测关节出血和关节痛鉴别诊断中的关键作用,重点介绍了通过使用人工智能和远程医疗进行长期关节健康监测的可行性。文献检索方法包括使用关键词在 PubMed 和 Google Scholar 中搜索,并且由本综述的共同作者筛选出使用的文章。

专家意见

关节超声是一种实用的即时护理工具,具有许多优点,包括成像与临床表现之间的直接关联,以及对多个关节的动态评估。远程医疗护理与人工智能辅助的即时检测设备相结合具有更早诊断和治疗关节出血的潜力。包括物理医学和康复(PMR)医生和物理治疗师在内的多学科方法对于确保患者获得最佳生活质量至关重要。

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