Evaluation of Point-of-Care Ultrasound in Paediatric Haemophilic Arthropathy: A Prospective Comparative Study With Comprehensive Ultrasound and MRI.
Rutten, Caroline Soliman, Magdy Panwar, Jyoti Mohanta, Arun Zhou, Alex Hilliard, Pamela Rayner, Tammy Weiss, Ruth Man, Carina Moineddin, Rahim
Rutten, Caroline
Soliman, Magdy
Panwar, Jyoti
Mohanta, Arun
Zhou, Alex
Hilliard, Pamela
Rayner, Tammy
Weiss, Ruth
Man, Carina
Moineddin, Rahim
Affiliation
University of Toronto; The Dudley Group NHS Foundation Trust; Tweed Hospital et al
Other Contributors
Publication date
2025/06/16
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
To evaluate the diagnostic accuracy of point-of-care (POC) ultrasound (US) in detecting joint changes in haemophilic arthropathy compared to comprehensive US, physical examination and MRI. Single-centre, prospective study examining 22 ankles, eight knees and nine elbows of 28 subjects (median/range, 16/6-27 years) with inherited bleeding disorders. Same-day physical and imaging joint assessment was performed using Haemophilia Joint Health Score (HJHS) 2.1, POC-US, comprehensive US and MRI. Two readers reviewed the imaging studies using standardized scoring systems. The inter-reader agreement was assessed with weighted kappa statistics. Diagnostic test performance of POC-US and comprehensive US was benchmarked against MRI findings using sensitivity, specificity, predictive values and accuracy. Spearman correlation was used to correlate physical examination and imaging findings. Moderate inter-reader agreement was observed for soft-tissue changes (kappa = 0.58), which was lower than comprehensive US (kappa = 0.76) and MRI (kappa = 0.77). Agreement for osteochondral lesions was poor (? 0.09), trailing behind comprehensive US (kappa = 0.55) and MRI (kappa = 0.75). POC-US showed reduced accuracy across all joint parameters in the elbows and ankles compared to comprehensive US, but comparable diagnostic performance in the knees. A good correlation was noted between total POC-US scores and HJHS (r = 0.68, p < 0.0001), similar to comprehensive US (r = 0.66, p < 0.0001). POC-US is valuable for assessing soft-tissue changes in haemophilic arthropathy, correlates satisfactorily with physical examination, but its accuracy is inferior to comprehensive US for ankles and elbows. Both POC-US and comprehensive US should be employed cautiously for assessing osteochondral joint abnormalities.
Citation
Rutten C, Soliman M, Panwar J, Mohanta A, Zhou A, Hilliard P, Rayner T, Weiss R, Man C, Moineddin R, Carcao M, Bouskill V, Stimec J, Dindial K, Tetzlaff D, Blanchette In Memoriam VS, Doria AS. Evaluation of Point-of-Care Ultrasound in Paediatric Haemophilic Arthropathy: A Prospective Comparative Study With Comprehensive Ultrasound and MRI. Haemophilia. 2025 Jul;31(4):787-798. doi: 10.1111/hae.70049. Epub 2025 May 19