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Master Thesis

Apport de l’échodoppler systématique en pratique courante dans l’arthropathie hémophilique

Abstract : Haemophilic arthropathy, although it has been significantly improved by clotting factor replacement, is the main cause of morbidity in severe and moderate hemophilia. In a will of early detection of joint lesions in order to limit their functional consequences, ultrasound has recently established itself as the imaging modality of choice in hemophilic arthropathy, due to its availability and high reliability, especially for synovial assessment. The contribution of power Doppler, on the other hand, remains to be specified, with very few and contradictory studies, but could be interesting to assess more precisely the activity of the disease, by differentiating fibrous synovial hypertrophies sequelae from active synovitis with vascular remodeling. This single-center, cross-sectional prospective study, including 34 hemophiliac patients and studying 199 joints, aimed to describe the ultrasound characteristics of the patients seen at the multidisciplinary rheumatology - hemophilia consultation of the Bordeaux University Hospital and to highlight the characteristics of patients with a positive doppler signal on joint ultrasound. We found a total of 18 hyperhemic synovitis (10% of the joints studied) in 12 patients (35% of patients), half of which were asymptomatic. Patients with doppler synovial hyperemia had a higher rate of poor adherence to their prophylactic treatment and a higher rate of on-demand treatment compared to those with synovial hypertrophy without a Doppler signal. These elements support the interest of power Doppler in the assessment of hemophilic joint involvement, potentially indicating poor disease control and thus progressive joint degradation.
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https://dumas.ccsd.cnrs.fr/dumas-03447710
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Submitted on : Wednesday, November 24, 2021 - 6:18:59 PM
Last modification on : Friday, December 17, 2021 - 3:47:07 AM

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  • HAL Id : dumas-03447710, version 1

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Léa Luchetti. Apport de l’échodoppler systématique en pratique courante dans l’arthropathie hémophilique. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03447710⟩

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