Twenty-one affected elbows in 14 known hemophilic patients undergoing treat
ment at the Hemophilia Clinic of our institution between 1994 and 1997 were
evaluated using the clinical evaluation score of the Orthopaedic Advisory
Committee of the World Federation of Hemophilia and radiological examinatio
n using the Pettersson score. The mean age of patients was 16.2 years (rang
e 10-25 years), and all patients except 1 had severe hemophilia with factor
VIII levels less than 1% of normal. The mean duration of disease at the ti
me of presentation was 12.8 years. The mean clinical score was 6, while the
mean radiological score was 4.9. There was a positive correlation between
the clinical and radiological scores (P < 0.0001). However, the clinical an
d radiological scores did not correlate with either duration of disease or
joint bleeding score. Two new radiological signs of obliteration of the cap
itello-lateral epicondyle groove with rounding off of the lateral aspect of
the distal humerus and ripping of the medial trochlear surface were also r
ecognized in hemophilic arthropathy of the elbow. Attempts have been made i
n the past to classify cases with hemophilic arthropathy based on the clini
cal and the radiological signs. Pettersson et al. [10] introduced a score b
ased on certain representative changes seen on plain radiography. The Ortho
paedic Advisory Committee of the World Federation of Hemophilia accepted th
e Pettersson score in 1981, and incorporated it in a point-based, clinico-r
adiologic comprehensive classification [5]. The present study applies this
classification to quantify the changes of hemophilic arthropathy of the elb
ow joint: and attempts to correlate the degree of joint involvement graded
by radiological criteria with clinical grading of the arthropathy.