Diagnostic accuracy of Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US): a comparative magnetic resonance imaging (MRI) study

  • Domen Plut Clinical Radiology Institute, University Medical Centre Ljubljana, Ljubljana, Slovenia Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  • Barbara Faganel Kotnik Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  • Irena Preložnik Zupan Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  • Damjana Ključevšek Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  • Gaj Vidmar University Rehabilitation Institute Republic of Slovenia, Ljubljana, Slovenia Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  • Žiga Snoj
  • Carlo Martinoli School of Medicine and Pharmacy, University of Genoa, Genoa, Italy
  • Vladka Salapura Clinical Radiology Institute, University Medical Centre Ljubljana, Ljubljana, Slovenia Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

Abstract

Background: Repeated haemarthroses affect approximately 90% of patients with severe haemophilia and lead to progressive arthropathy, which is the main cause of morbidity in these patients. Diagnostic imaging can detect even subclinical arthropathy changes and may impact prophylactic treatment. Magnetic resonance imagining (MRI) is generally the gold standard tool for precise evaluation of joints, but it is not easily feasible in regular follow-up of patients with haemophilia. The development of the standardized ultrasound (US) protocol for detection of early changes in haemophilic arthropathy (HEAD-US) opened new perspectives in the use of US in management of these patients. The HEAD-US protocol enables quick evaluation of the six mostly affected joints in a single study.

The aim of this prospective study was to determine the diagnostic accuracy of the HEAD-US protocol for the detection and quantification of haemophilic arthropathy in comparison to the MRI.

Patients and methods: The study included 30 patients with severe haemophilia. We evaluated their elbows, ankles and knees (overall 168 joints) by US using the HEAD-US protocol and compared the results with the MRI using the International Prophylaxis Study Group (IPSG) MRI score.

Results: The results show that the overall HEAD-US score correlates very highly with the overall IPSG MRI score (r=0.92). Correlation is very high for the evaluation of the elbows and knees (r≈0.95), and slightly lower for the ankles (r≈0.85).

Conclusions: HEAD-US protocol proved to be a quick, reliable and accurate method for the detection and quantification of haemophilic arthropathy.

Author Biographies

Domen Plut, Clinical Radiology Institute, University Medical Centre Ljubljana, Ljubljana, Slovenia Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Pediatric radiology
Barbara Faganel Kotnik, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Pediatric haematooncology
Irena Preložnik Zupan, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Haematology
Damjana Ključevšek, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Pediatric radiology
Gaj Vidmar, University Rehabilitation Institute Republic of Slovenia, Ljubljana, Slovenia Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Statistician
Žiga Snoj
Clinical Radiology Institute, University Medical Centre Ljubljana, Ljubljana, Slovenia

Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Carlo Martinoli, School of Medicine and Pharmacy, University of Genoa, Genoa, Italy
Radiology
Vladka Salapura, Clinical Radiology Institute, University Medical Centre Ljubljana, Ljubljana, Slovenia Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Skeletal radiology
Published
2019-06-06
How to Cite
Plut, D., Faganel Kotnik, B., Preložnik Zupan, I., Ključevšek, D., Vidmar, G., Snoj, Žiga, Martinoli, C., & Salapura, V. (2019). Diagnostic accuracy of Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US): a comparative magnetic resonance imaging (MRI) study. Radiology and Oncology, 53(2), 178-186. Retrieved from https://www.radioloncol.com/index.php/ro/article/view/3235
Section
Radiology