Hemophilic Artheropathces Treatment By Interaarticular Rifampin Injection

Hemophilic arthropathy due to repeated intraarticular bleeding leads to reduction of quality of life in hemophiliacs.There are variety of methods in prevention and treatment of joints complications in patients, which intraarticular rifampin injection is the most cheapest, less complicating and more beneficial one. Among patients referring to hemophilic clinic of Ahwaz shafa hospital, we selected patients that had target joints or chronic synovitis.Pre and post treatment (3 to 6 months later) clinical examination (by world federation of hemophilia guideline) and MRI of involved joints were performed.In knee rifampin 500mg lidocaine, weekly for 10 weeks and in elbow, ankle and shoulder joints 250mg rifampin lidocoine, for 5 weeks injected intraarticularly. The factor patients levels reached to 50-80 percent in the day of injection and the following days.Intraarticular injections were performed for 9 hemophilic patients with 11 affected hemophilic joints clinical signs and MRI showed dramatic improvement in 6 patients, but out come was not favorable in 3 patients due to advanced disease and joint destruction. Intraarticular rifampin injection is a suitable method for prevention of bleeding, improvement of clinical signs and quality of life in hemophiliacs.MRI is more helpful in reviewing the therapeutic results and Joint chonges after treatment.Hyperplasia and hypertrophy of synovium, bone cysts,joint cartilage loss,precipitation of hemosiderin and osteonecrosis are evaluated with MRI better and precisely than plain radiography or clinical examination, pre and post treatment.