The Utility of Knee Ultrasound in Patients With Hemophilia Who Present With Knee Pain or Swelling at the Hemophilia Clinic in Kenyatta National Hospital

Abstract

Background; Hemophilia is among the diseases that have not received adequate attention from the critical health decision-makers, despite the increasing number of patients diagnosed with the disease locally and across the world. Among the patients with hemophilia, bleeding into the joints, principally the knee joint, is common. A timely diagnosis of hemarthrosis and its complications is critical in optimal care for patients with hemophilia. MRI is the gold standard for the joint assessment in hemophilia, but access to MRI is limited by cost and scarcity. Ultrasonography is a valuable alternative, but the use of musculoskeletal sonography is not widespread locally. There is no available local data regarding the utility of ultrasound in the assessment of the knee joint of patients with hemophilia. Objective; This study was designed to assess the utility of ultrasound in the assessment of the knee joint of patients with hemophilia who presented with knee pain or knee swelling at the hemophilia clinic in Kenyatta National Hospital, Nairobi, Kenya. Setting; The National Hemophilia Clinic is located within the Kenyatta National Hospital in Nairobi, Kenya. Patients with hemophilia are followed in the Hemophilia clinic, where concentrate therapy and hemophilia complications are managed. Study design; This study was a cross-sectional descriptive study. Study subjects; A total of 41 patients with hemophilia and knee pain or knee swelling were assessed. Study method; This study was conducted over four months from February 2021 to April 2021. A total of 41 patients who have hemophilia and who attended the 11 routinely scheduled hemophilia clinic were recruited for the study. Both clinical assessment of the knee and sonographic assessment of the knees was done, and results recorded in the data collection form. Statistical analysis was done with SPSS version 2.0 to correlate the ultrasound findings with clinical findings. Data management; All the relevant data was obtained directly from the participant and recorded in the Data Collection Form attached. The standard images obtained were filed and labeled accordingly. Statistical analysis was done using the Statistical Package for Social Scientists (SPSS). Expected main outcome measure(s); It is expected that the number of MSK ultrasounds carried out in KNH hemophilia clinic will increase after this study resulting in early detection of hemophilic arthropathy. This outcome was measured by the primary register of ultrasound scans done on the KNH hemophilia clinic patients within the study period