Fig. 2.

Examples of musculoskeletal assessments in (a) children with haemophilia presenting with subclinical arthropathy and (b) patients with haemophilia who are presenting with an acute bleed. ^∗Ultrasound is used to show early structural changes such as low-degree synovitis, chondral changes and bony changes (not central). Immediate ultrasound can detect a bleed or effusion, which will impact on Factor VIII therapy and could lead to additional treatment, such as lymphatic drainage, in the physiotherapy rehabilitation plan. However, ultrasound would not be available in a home-treatment setting. CWH, children with haemophilia; MSK, musculoskeletal; PWH, patients with haemophilia.