Hemarthrosis is a condition in which blood vessels in a joint are damaged, causing bleeding or blood clots around the joint. It usually occurs in the shoulder or knee joints. People with hemarthrosis will experience pain, swelling, and bruising around the joint, and it can affect their movement in the short and long term.
Hemarthrosis often occurs after an injury or accident, and is a common complication in people with bleeding disorders, such as hemophilia or bleeding disorders .
Hemarthrosis symptoms
Hemarthrosis can range in severity from moderate to severe, with symptoms becoming more severe if there is a large amount of bleeding. Common symptoms include:
- Feeling warm around the joint
- Feeling pain in the joints or tingling in the joints
- The skin around the joint is swollen, red, bruised , and painful when pressed.
- Feeling stiff and tight in the joints, unable to fully stretch or bend.
Hemarthrosis requires appropriate treatment. If you have these symptoms, you should see a doctor, especially those with abnormal bleeding, who are at high risk of developing hemarthrosis.
Causes of Hemarthrosis
Hemarthrosis can be caused by a number of factors , especially conditions that cause abnormal blood clotting, such as:
- Bleeding disorders result in the body not being able to make blood-clotting proteins, especially in patients with severe hemophilia who may experience hemarthrosis up to 1–2 times/week.
- Taking antiplatelet drugs such as aspirin or anticoagulants such as warfarin.
- Have a vitamin K deficiency .
- Have severe kidney or liver disease
Other health conditions that may lead to Hemarthrosis
- Injuries that occur in the joint area, such as sprains, strains, or tears of the tendons and ligaments , are a common cause.
- Osteoarthritis or septic arthritis often results in deterioration of the joints and rupture of the cartilage or intervertebral discs.
- The growth of tumors or cancer cells (neoplasms) that may block blood vessels or expand and squeeze blood vessels until they rupture, causing hemarthrosis.
- Complications from joint surgery, especially the knee
Diagnosis of Hemarthrosis
To initially diagnose hemarthrosis, your doctor will ask about your medical history, recent injuries, and family history of hemophilia, and examine any joints that are painful, swollen, or bruised.
Including other diagnostic methods to find the cause of Hemarthrosis and plan appropriate treatment, such as:
- X-rays or magnetic resonance imaging (MRI) to look for damage to tissue or cartilage.
- Joint aspiration is a procedure in which a needle is inserted into a joint to collect a sample of joint fluid for examination. Joint fluid that may indicate hemarthrosis is usually red, pink, or brown. However, if the patient already has osteoarthritis, the doctor will not perform this diagnosis.
- A blood test that measures the amount of a protein that helps the blood clot.
Hemarthrosis Treatment
The treatment method for Hemarthrosis depends on the cause of the condition. In cases where the cause of Hemarthrosis is a simple injury, the doctor will focus on relieving pain and reducing swelling. In cases where it is a complication of abnormal bleeding, the treatment will focus on stopping the flow of blood.
First aid treatment
First aid can be done by providing first aid to reduce injury and swelling according to the RICE principle, which stands for:
- Rest The patient must refrain from moving the injured joint, using crutches or other support devices instead.
- Ice Cold compress
- Compression: Using an elastic bandage to wrap around the injured area.
- Elevation Elevating the injured area
Drug treatment
Doctors may prescribe medications that help clot the blood in patients with bleeding disorders. For example, tranexamic acid helps stop the breakdown of blood clots. However, blood clotting medications can cause side effects. Currently, there is a preventive treatment called prophylactic factor replacement therapy , which is given to patients with moderate to severe hemophilia.
People with Hemarthrosis should not buy painkillers to take by themselves because many over-the-counter painkillers are drugs that work to prevent blood clotting, making it harder for the blood to stop flowing, such as aspirin, ibuprofen, and naproxen. Use the drugs only as advised by your doctor.
Surgical treatment
Surgical treatment is used in cases of severe hemarthrosis or when other treatment methods have not worked. It may involve a synovectomy or a joint replacement surgery to reduce pain, allow the patient to move more easily and perform daily activities better.
Physical therapy
Physical therapy helps patients restore their body and proper movement to prevent further damage to the joint. Physical therapy may be used as a stand-alone treatment or as an adjunct after joint drainage or surgery.
There is also a treatment for pain relief using transcutaneous electrical nerve stimulation (TENS), but it is not commonly used to treat this condition.
Complications of Hemarthrosis
Patients with recurrent or severe hemarthrosis may develop long-term complications in the joints. When there is bleeding in the joints, it damages the tissues, tendons, muscles, ligaments, and cartilage in the joints. The tissues within the joints may become scarred, which will have long-term effects, making it difficult to move the joints.
In addition, if a joint bleed occurs once, it increases the risk of repeated joint bleeds in the same area, resulting in weak muscles in the joints, pain in the joints even when still, making it difficult to do daily activities, and may lead to osteoarthritis, which is caused by cartilage destruction.
Hemarthrosis Prevention
Since the factors that cause Hemarthrosis are often from injuries, accidents or complications of hemophilia, prevention focuses on taking precautions to avoid accidents or injuries to the joints and reducing the risk of bleeding in people with hemophilia, such as:
- Exercise to keep your body fit and control your weight to prevent obesity. Being overweight increases pressure in your joints, causing wear and tear or osteoarthritis, which increases your risk of developing Hemarthrosis.
- Eat foods that contain enough calcium and vitamin D to build strong bones and joints.
- Drive carefully and always fasten your seat belt correctly when riding in a car.
Wear protective gear and keep your body in the correct position when playing sports to prevent injury. - People with hemophilia should avoid taking anticoagulant medications, avoid activities that pose a risk of injury, and may need regular injections of a blood-clotting protein to prevent bleeding that does not stop.
