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Development and definition of a simplified scanning procedure and scoring method for Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US)

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
DOI: http://dx.doi.org/10.1160/TH12-11-0874
Issue: 2013: 109/6 (June) pp. 977–1185
Pages: 1170-1179

Development and definition of a simplified scanning procedure and scoring method for Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US)

C. Martinoli (1), O. Della Casa Alberighi (2), G. di Minno (3), E. Graziano (4), A. C. Molinari (5), G. Pasta (6), G. Russo (1), E. Santagostino (7), A. Tagliaferri (8), A. Tagliafico (9), M. Morfini (10)

(1) Radiologia – DISSAL, Università di Genova, Italy; (2) Direzione Scientifica – Unità di Farmacologia Clinica e Sperimentazioni Cliniche, IRCCS Istituto „G. Gaslini“, Genova, Italy; (3) Dipartimento di Medicina Clinica e Sperimentale. Università di Napoli, Italy; (4) Dipartimento di Medicina – Scienze dell’Invecchiamento. Università di Chieti-Pescara, Italy; (5) Unità di Trombosi ed Emostasi – IRCCS Istituto „G. Gaslini“, Genova, Italy; (6) Dipartimento di Ortopedia, Policlinico Universitario di Milano, Italy; (7) Centro di Emofila e Trombosi „AB Bonomi“, Policlinico Universitario di Milano, Italy; (8) Dipartimento di Medicina Interna – AOU Parma, Italy; (9) Istituto di Anatomia Umana – DIMES, Università di Genova, Italy; (10) Centro Emofilia – AOU “Careggi“ Firenze, Italy

Keywords

synovitis, Ultrasonography, haemophilic arthropathy, Joints, scoring systems, osteochondral damage

Summary

The aim of this study was to develop a simplified ultrasound scanning procedure and scoring method, named Haemophilia Early Arthropathy Detection with UltraSound [HEAD-US], to evaluate joints of patients with haemophilic arthropathy. After an initial consensus-based process involving a multidisciplinary panel of experts, three comprehensive and evidence-based US scanning procedures to image the elbow, knee and ankle were established with the aim to increase sensitivity in detection of early signs of joint involvement while keeping the technique easy and quick to perform. Each procedure included systematic evaluation of synovial recesses and selection of a single osteochondral surface for damage analysis. Based on expert consensus, a simplified scoring system based on an additive scale was created to define the joint status and, in perspective, to offer a tool to evaluate disease progression and monitor the result of treatment in follow-up studies.

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