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Hemophilia - History, Future, Cause and Potential Cure.
Symptoms and Treatment of Bleeding Episodes
Joint Bleeding
As the person with hemophilia grows, bleeding into his joints will occur more frequently. Early signs of bleeding are the reluctance to use the affected limb followed by a slight swelling in the affected joint. Attempts to move the joint forcibly cause pain.
As more blood leaks into the joint it feels warmer than the opposite one and the swelling feels "spongy". Later the person holds the limb in a bent or "flexed" position to ease pain. Flexion increases the space in the joint, making more room for further bleeding to occur.
If untreated, the bleeding continues until the area feels hot and rock hard. Usually there is no bruising associated with a joint bleed, and since the bleeding occurs in an enclosed space (the joint capsule) and has nowhere to spread, the pressure caused by the bleeding eventually results in pain -- which can be quite severe.
Early treatment with clotting factor usually prevents the pain from becoming severe, and since only a small amount of blood will have leaked into the joint space, recovery will be quick, although the joint will sustain some permanent damage.
In addition to pain considerations, inadequately treated bleeding irritates the joint surface which eventually leads to arthritis. A large volume of blood, which results from delayed treatment, takes longer to re-absorb into the body.
The longer the period of irritation, the greater the chance of arthritic damage. Early treatment of each bleeding episode will limit the amount of irritation and reduce the risk of arthritis. Strong muscles protect joints from some bleeding episodes. Therefore it is suggested that people with hemophilia exercise regularly.
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