Hemophilia is a bleeding disorder which can have profound musculoskeletal sequelae. Roughly 90% of patients with hemophilia suffer from spontaneous hemarthroses, many of which are recurrent. Typically, these hemarthroses are monoarticular and occur most frequently in the knee > elbow > ankle. Hemosiderin is deposited within the synovium of the affected joint leading to synovial hypertrophy, which in turn can lead to destruction of the underlying articular cartilage.

Radiographic appearance:

Acute findings

• joint effusion
• periarticular osteopenia

Chronic findings

• epiphyseal overgowth (e.g. widening of intracondylar notch in the knee) - may mimic findings of JRA
• pseudotumor formation (hematoma with thick fibrous capsule) - usually in the soft tissues but may compress adjacent bone
• osteoarthritic changes