OSTEONECROSIS OF THE FEMORAL-HEAD IN HEMOPHILIACS - NOT ALL JOINT DISEASE IS HEMOPHILIC ARTHROPATHY

Osteonecrosis (ON) is rare while arthropathy is common in persons with haemophilia. A recent case of bilateral ON of the femoral head prompt ed us to review our experience with hip arthroplasty. We identified ni ne patients with presumed end-stage haemophilic arthropathy. Four of t he nine individuals had radiographic findings suggestive of ON, but wi thout unequivocal microscopic evidence of ON. It is important to recog nize ON at an early stage because there are surgical interventions whi ch may prolong the life of the joint and improve quality of life. We s uggest that ON should be included in the differential diagnosis of hip pathology in persons with haemophilia presenting with hip pain or dys function.