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Radiological Case of the Month

Michael Heim, MB, ChB; Uri Martinowitz, MD; Henri Horoszowski, MD; Lionel W. Young, MD
Am J Dis Child. 1987;141(7):801-802. doi:10.1001/archpedi.1987.04460070103035.
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A 4-year-old male hemophiliac was transferred to the Israel National Hemophilia Center, Tel Hashomer, from a peripheral hospital. He had a severe, classic case of hemophilia and had been hospitalized frequently because of a swollen right knee. The patient had received infusions of bloodclotting factor VIII concentrate calculated on the basis of 15 U/kg. His right knee was contracted and constantly swollen (Figs 1 and 2) for six months prior to his referral. Knee roentgenograms were obtained (Figs 3 and 4).

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Denouement and Discussion 

Severe Chronic Hemophilic Synovitis Resulting in Epiphyseal Overgrowth  Fig 1.—Flexion contracture of right knee.Fig 2.—Right knee markedly swollen in comparison with left knee.Fig 3.—Lateral roentgenographic view of right knee showing greatly distended joint.Fig 4.—Posteroanterior roentgenographic view of both knees. Note increased size of right femoral epiphysis.The majority of bleeding episodes in hemophilia occur within


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