Despite the fact that synovitis is known as a sign of joint disease activity, it is not routinely assessed in patients with hemophilia (PWH). For a study, researchers focused on a preliminary literature search that was done by the Musculoskeletal Committee of the Italian Association of Hemophilia Centers (AICE) in order to evaluate existing knowledge and identify problematic topics. Statements had been developed and distributed to Italian AICE members in order to collect their degree of agreement or disagreement using a Delphi procedure. A total of 37 consensus proposals had been produced. They discovered widespread agreement on the suggestion to consider synovitis as a measure of joint disease activity in PWH. As a result, there was agreement on the indication to look for synovitis in both symptomatic and asymptomatic patients, with ultrasonography being recognized as the most practicable imaging tool for doing the periodic joint screening. 

Surprisingly, when synovitis was detected, there was agreement on the prescription to change the therapeutic strategy, advocating prophylaxis in patients treated on-demand and customizing therapy in patients already on prophylaxis. While it is suggested that PWH with chronic synovitis visit with a physiotherapist as soon as possible, the exact date for an orthopedic surgeon appointment was uncertain.

Reference:onlinelibrary.wiley.com/doi/10.1111/bjh.17919