Assessment of Musculoskeletal Changes and Related Factors in Children with Hemophilia

Abstract

INTRODUCTION: We aimed to investigate the musculoskeletal changes and related factors in children with hemophilia. MATERIALS and METHODS: Thirty-five children with hemophilia enrolled the study. Joint damage and its stage were evaluated by using physical examination, hemorrhage and radiological scoring in patients with target joints. In addition, the role and association of the treatment modalities, bone mineral density (BMD) and serum vitamin D levels of the patients in both target joint development and the stage of the damage were evaluated. RESULTS: Target joint was detected in 34.2% of the patients. BMD and serum vitamin D levels were similar in both groups with and without target joints. Vitamin D levels were lower than normal in 50% of the patients and BMD values were lower than normal (Z-score<-2) in 17% of the patients with target joint. No significant correlation was determined between BMD and physical examination scoring, radiological scoring or serum vitamin D levels. At the same time, there was no significant correlation between the serum vitamin D level and physical examination or radiological scoring. However, physical examination and radiological scorings were significantly correlated. BMD and vitamin D levels were not affected by patient's age, type of hemophilia or severity of disease. No iron deficiency anemia was observed in patients. CONCLUSIONS: Target joint was detected in approximately 1/3 of the children with hemophilia. Different stages of the injuries were detected in these joints by physical and radiological examinations. BMD and serum vitamin D levels had no association in development of target joint and the stage of the damage in these patients with severe hemophilia.