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The management of a person with haemophilia who has a fixed flexed hip and intractable pain
Author(s) -
Michael Heim,
David Varon,
Simon Strauß,
Uri Martinowitz
Publication year - 1998
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1046/j.1365-2516.1998.00203.x
Subject(s) - medicine , haemophilia , bleed , presentation (obstetrics) , narcotic , surgery , joint contracture , joint pain , pain management , haemophilia a , rehabilitation , contracture , physical therapy
The clinical picture of a fixed flexed hip associated with pain in a person with haemophilia is suggestive of a haemorrhage in that area. Sonography facilitates differentiation between a haemarthrosis, intraperitoneal haemorrhage, subperiosteal bleed, a bleed into the soft tissue around the hip joint or a psoas haematoma. All these aforementioned causes may result in the same clinical presentation. Two cases are described in which coxhaemarthrosis resulted in a flexion contracture of the joint associated with severe intractable pain. Narcotic drugs failed to alleviate the severe pain. Joint aspiration produced dramatic pain relief and early joint rehabilitation.