血友病患者關節症狀與影像學之相關性

Correlation of Joint Symptoms and Imaging Studies among Patients with Hemophilia

陳彥均(Yen-Chun Chen) ； 魏大森(Ta-Sen Wei) ； 吳宗儒(Tsung-Ju Wu) ； 劉真真(Chen-Chen Liu) ； 沈銘鏡(Ming-Ching Shen)

《台灣復健醫學雜誌》 39卷2期 (2011/06) Pp. 95-103

https://doi.org/10.6315/2011.39(2)04

摘要

Hemophilia is an Ⅹ-linked congenital bleeding disorder, with deficiency of coagulation factor Ⅷ (hemophilia A) or factor Ⅸ (hemophilia B). Hemophilia patients often have hemarthrosis with severe joint pain, which results in joint immobility and subsequent muscle atrophy, joint contracture, and gait disturbance. This study investigated the symptoms and severity, joint involvement, and imaging findings of hemophilia patients in Taiwan.
A total of 51 male participants, including 40 with hemophilia A, aged from 6 to 69 years (mean age: 27.2±15.6 years), were recruited. We evaluated clinical symptoms and joint conditions using the Colorado Physical Examination, and imaging findings using the Pettersson score.
According to the Colorado Physical Examination, the most frequently involved joint was the knee, followed by the ankle, elbow, and hip. According to the Pettersson score, the most frequently involved joint was the ankle, then elbow, knee, hip, and shoulder. The degree of severity was greater in the ankle, then knee, upon evaluation with the Colorado Physical Examination; with the Pettersson score, the greatest severity occurred in the knee, then ankle. Right side joints of lower limbs had greater symptom severity than left side limbs, especially with the right knee (Colorado Physical Examination, p=0.026). The incidence of joint involvement increased with age (Pearson's correlation coefficient=0.29-0.65, p＜0.001), and the greatest correlation was with the right knee. High correlation was found between the Colorado Physical Examination and Pettersson scores (Pearson's correlation coefficient=0.64-0.80).
In Taiwan, hemophilia arthropathies are most severe in the knee and ankle, especially on the right side. Most hemophilia patients have gait disturbances and symptoms even though there are no significant findings on imaging studies. Therefore, patients must receive regular clinical evaluations for early detection of joint dysfunction, and for appropriate rehabilitation programs and orthotic intervention.

關鍵字

血友病 ； 關節病變 ； Colorado量表 ； Pettersson量表

並列摘要

Hemophilia is an Ⅹ-linked congenital bleeding disorder, with deficiency of coagulation factor Ⅷ (hemophilia A) or factor Ⅸ (hemophilia B). Hemophilia patients often have hemarthrosis with severe joint pain, which results in joint immobility and subsequent muscle atrophy, joint contracture, and gait disturbance. This study investigated the symptoms and severity, joint involvement, and imaging findings of hemophilia patients in Taiwan.
A total of 51 male participants, including 40 with hemophilia A, aged from 6 to 69 years (mean age: 27.2±15.6 years), were recruited. We evaluated clinical symptoms and joint conditions using the Colorado Physical Examination, and imaging findings using the Pettersson score.
According to the Colorado Physical Examination, the most frequently involved joint was the knee, followed by the ankle, elbow, and hip. According to the Pettersson score, the most frequently involved joint was the ankle, then elbow, knee, hip, and shoulder. The degree of severity was greater in the ankle, then knee, upon evaluation with the Colorado Physical Examination; with the Pettersson score, the greatest severity occurred in the knee, then ankle. Right side joints of lower limbs had greater symptom severity than left side limbs, especially with the right knee (Colorado Physical Examination, p=0.026). The incidence of joint involvement increased with age (Pearson's correlation coefficient=0.29-0.65, p＜0.001), and the greatest correlation was with the right knee. High correlation was found between the Colorado Physical Examination and Pettersson scores (Pearson's correlation coefficient=0.64-0.80).
In Taiwan, hemophilia arthropathies are most severe in the knee and ankle, especially on the right side. Most hemophilia patients have gait disturbances and symptoms even though there are no significant findings on imaging studies. Therefore, patients must receive regular clinical evaluations for early detection of joint dysfunction, and for appropriate rehabilitation programs and orthotic intervention.

並列關鍵字

hemophilia ； arthropathy ； Colorado physical examination ； Pettersson score