الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Arthropathy is a frequent and serious complication of repeated joint bleeding in patients with hemophilia, resulting in pain, deformity, and disability. Over time, recurrent bleeding into the same joint (a target joint) results in progressive damage and the development of HA. Although the pathogenesis of HA has not been fully elucidated, it appears to have similarities with the degenerative joint damage that occurs in OA and the inflammatory processes associated with RA.
Some biomarkers such as U-CTX-II appear to correlate with severity of joint degeneration, whereas others are less distinctive. These biomarkers are molecules or fragments that are released into biologic fluids during the process of tissue turnover. Thus the specific characteristics of HA might be useful in future evaluations of such cartilage-derived biomarkers and emphasizes the usefulness of U/S in early diagnosis of the initial stages of HA.
The aim of the current study was to evaluate joint damage in boys with hemophilia using ultrasonography, and to estimate biomarker of cartilage turnover U-CTX-II and to determine its relation to the degree of HA.
The study was carried out on two groups. Group (I): Thirty boys with hemophilia with a history of previous joint bleed, their age ranged from 6 to 15 years with a mean of 11.0 ± 2.75years.They were selected from those attending the outpatient Hematology Clinic of Alexandria University Children’s Hospital at Elshatby between January 2012 and June 2012. Group (II): Ten healthy children were also included as control subjects with matched age and sex.
All patients were cooperative and had a history of joint bleeds (hemarthrosis). All patients with comorbid illness that causes osteoarticular findings or may obscure or confound the hemophilia-based joint findings, those with active bleed within one week, and prior synovectomy were excluded from the study.
All studied groups were subjected to the following:
• Recording of historical data for patients with special emphasis on history of previous joint bleeds.
• General examination and registration of anthropometric measures.
• Thorough local clinical assessment of the most affected and/or target joint using WFH clinical score (Gilb