Joint by Joint Correlations Between Ultrasound Head-US Scores and HJHS Joint Scores in Hemophilia A Patients: A National, Multi-Center, Prospective, and Cross-Sectional Study

Abstract

Objective: Hemophilia Joint Health Score (HJHS) and Hemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) Score are indispensable tools for the routine evaluation of joint health in individuals with hemophilia A. This study aims to meticulously evaluate the joint-specific correlations between the HJHS and HEAD-US scoring systems in hemophilia A patients, focusing on the elbow, knee, and ankle joints. Material and Methods: A comprehensive national, multicenter, prospective, cross-sectional, non-interventional observational study was conducted across 19 medical centers in Türkiye, involving 192 hemophilia A patients over a two-year duration. The inclusion criteria encompassed patients aged ≥6 years with moderate or severe hemophilia A (FVIII<2%), comprising 63.5% pediatric and 36.5% adult patients. Results: In the analysis of 192 patients under prophylactic treatment, a robust correlation was identified between the HJHS and HEAD-US total scores across all age groups. Particularly noteworthy was the finding that adults exhibited a more pronounced correlation than their pediatric counterparts for total scores. When exploring the correlation among the six joints, it became apparent that elbows exhibited the highest correlation (r: 0.408/0.581), while ankles demonstrated the lowest correlation (r: 0.397/0.311). Furthermore, the study uncovered an intriguing insight: a significant difference in correlation rates between children and adults, adding a layer of complexity to the joint evaluation process. Conclusion: The HEAD-US and HJHS scoring systems serve as valuable monitoring tools in hemophilia A, offering complementary insights. Our findings highlight varying correlation rates among joints, emphasizing elbows as the most correlated joints. © 2024 by Türkiye Klinikleri.