{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T19:29:12Z","timestamp":1793647752903,"version":"4.5.1"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"42","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Sichuan Province Medical Research Project Pla","award":["S18068"],"award-info":[{"award-number":["S18068"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10,16]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      This study explores the feasibility and perceptions of using ultrasound (US) for identifying subclinical abnormalities in hemophilic joints from the perspectives of both patients and medical practitioners. This was a single-center pilot follow-up study that included multidisciplinary medical professionals and severe hemophilia patients. The Hemophilia Early Arthropathy Detection with Ultrasound in China (HEAD-US-C) scale and Hemophilia Joint Health Score (HJHS) 2.1 were utilized to assess joint conditions. Inter-rater agreement for HEAD-US-C scoring on stored US images was evaluated. Data from 13 multidisciplinary doctors and 28 patients (112 joints: 40 elbows, 24 knees, 48 ankles) were analyzed. Among 40 joints without reported bleeding during follow-up, US total scores increased in 25.0% (10\/40), whereas HJHS scores increased in 12.5% (5\/40). Among the 78 joints with unchanged HJHS scores, US detected increased structural scores in 21.8% (17\/78) of joints. Conversely, among the 66 joints with unchanged US scores, only 9.1% (6\/66) exhibited HJHS score changes &gt;0. At the joint level, HEAD-US-C scores were positively correlated with HJHS scores (repeated measures correlation coefficient\u2005=\u20050.757, 95% CI 0.648\u20130.835,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005&lt;\u2005.001). US was perceived as useful by 69.2% of doctors (38.5% very useful, 30.8% somewhat useful), and US-based visual explanations were perceived as useful by all patients. The overall linear weighted kappa for patient-level aggregated HEAD-US-C scores assigned by the 2 sonographers was 0.903 (95% CI 0.871\u20130.935). US assessment using the HEAD-US-C scale appeared feasible and was well accepted by doctors and patients. In this pilot study, US identified increased structural scores in some joints without corresponding HJHS changes, suggesting that it may provide complementary structural information to clinical joint assessment. The findings also showed a positive association between HEAD-US-C scores and HJHS scores and high inter-rater agreement for HEAD-US-C scoring on stored US images. However, this study was not designed to demonstrate superiority over HJHS, diagnostic performance, improved medication adherence, or complete reliability of the HEAD-US-C scoring system.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/md.0000000000051155","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:01:55Z","timestamp":1792173715000},"page":"e51155","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility and perceptions among hemophilia patients and doctors towards ultrasound for the assessment of subclinical abnormalities in hemophilic joints"],"prefix":"10.1097","volume":"105","author":[{"given":"Ming","family":"Ye","sequence":"first","affiliation":[{"name":"Ultrasound Department, The Third People\u2019s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Ultrasound Department, The Third People\u2019s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Ultrasound Department, The Third People\u2019s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Third People\u2019s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Third People\u2019s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shen","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, The Third People\u2019s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Yang","sequence":"additional","affiliation":[{"name":"Ultrasound Department, The Third People\u2019s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaxi","family":"Li","sequence":"additional","affiliation":[{"name":"Ultrasound Department, The Third People\u2019s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zeng","sequence":"additional","affiliation":[{"name":"Ultrasound Department, The Third People\u2019s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changyu","family":"Chen","sequence":"additional","affiliation":[{"name":"Siemens Healthineers Ultrasound Division, Chengdu, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5031-0347","authenticated-orcid":false,"given":"Yang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Ultrasound Department, The Third People\u2019s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20261102","doi-asserted-by":"crossref","first-page":"2112","DOI":"10.1111\/jth.15444","article-title":"Hemophilic arthropathy: current knowledge and future perspectives.","volume":"19","author":"Gualtierotti","year":"2021","journal-title":"J Thromb Haemost"},{"key":"R2-20261102","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/hae.13088","article-title":"Choosing outcome assessment tools in haemophilia care and research: a multidisciplinary perspective.","volume":"23","author":"Fischer","year":"2017","journal-title":"Haemophilia"},{"key":"R3-20261102","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1080\/08880018.2017.1313921","article-title":"Efficacy of standard prophylaxis versus on-demand treatment with bayer\u2019s sucrose-formulated recombinant FVIII (rFVIII-FS) in Chinese children with severe hemophilia A.","volume":"34","author":"Zhao","year":"2017","journal-title":"Pediatr Hematol Oncol"},{"issue":"Suppl 6","key":"R4-20261102","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/hae.14046","article-title":"WFH guidelines for the management of hemophilia, 3rd edition.","volume":"26","author":"Srivastava","year":"2020","journal-title":"Haemophilia"},{"key":"R5-20261102","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1111\/hae.14861","article-title":"Subclinical synovial proliferation in patients with severe haemophilia A: the value of ultrasound screening and biochemical markers.","volume":"29","author":"van Bergen","year":"2023","journal-title":"Haemophilia"},{"key":"R6-20261102","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1016\/j.jtha.2023.01.035","article-title":"Magnetic resonance imaging evidence for subclinical joint bleeding in a Dutch population of people with severe hemophilia on prophylaxis.","volume":"21","author":"van 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(HEAD-US).","volume":"109","author":"Martinoli","year":"2013","journal-title":"Thromb Haemost"},{"key":"R10-20261102","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/hae.14280","article-title":"Ultrasound evaluation of joint damage and disease activity in adult patients with severe haemophilia A using the HEAD-US system.","volume":"27","author":"Jim\u00e9nez-Yuste","year":"2021","journal-title":"Haemophilia"},{"key":"R11-20261102","first-page":"132","article-title":"Clinical application and optimization of HEAD-US quantitative ultrasound assessment scale for hemophilic arthropathy.","volume":"39","author":"Li","year":"2018","journal-title":"Zhonghua Xue Ye Xue Za Zhi"},{"key":"R12-20261102","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1080\/16078454.2021.2019892","article-title":"Joint status and related risk factors in patients with severe hemophilia A: a single-center cross-sectional study.","volume":"27","author":"Zhao","year":"2022","journal-title":"Hematology"},{"key":"R13-20261102","doi-asserted-by":"crossref","first-page":"e51","DOI":"10.1111\/hae.12268","article-title":"Comparison of ultrasound and magnetic resonance imaging for diagnosis and follow-up of joint lesions in patients with haemophilia.","volume":"20","author":"Sierra Aisa","year":"2014","journal-title":"Haemophilia"},{"key":"R14-20261102","doi-asserted-by":"crossref","first-page":"e253","DOI":"10.1111\/hae.14245","article-title":"Haemophilia early arthropathy detection with ultrasound and haemophilia joint health score in the moderate haemophilia (MoHem) study.","volume":"27","author":"M\u00e5seide","year":"2021","journal-title":"Haemophilia"},{"key":"R15-20261102","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1002\/jum.16367","article-title":"Diagnostic value of the HEAD-US-C scale for the knees of severe hemophilia A patients.","volume":"43","author":"Fang","year":"2024","journal-title":"J Ultrasound Med"},{"key":"R16-20261102","doi-asserted-by":"crossref","first-page":"e12690","DOI":"10.1002\/rth2.12690","article-title":"The hemophilia joint health score version 2.1 validation in adult patients study: a multicenter international study.","volume":"6","author":"St-Louis","year":"2022","journal-title":"Res Pract Thromb Haemost"},{"key":"R17-20261102","doi-asserted-by":"crossref","first-page":"e141","DOI":"10.1111\/hae.13147","article-title":"Comparing findings of routine haemophilia joint health score and haemophlia early arthropathy detection with ultrasound assessments in adults with haemophilia.","volume":"23","author":"Timmer","year":"2017","journal-title":"Haemophilia"},{"key":"R18-20261102","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1111\/jth.12113","article-title":"Musculoskeletal health of subjects with hemophilia A treated with tailored prophylaxis: Canadian hemophilia primary 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haemophilia A.","volume":"19","author":"Di Minno","year":"2013","journal-title":"Haemophilia"},{"key":"R22-20261102","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1002\/jum.14846","article-title":"Development and reliability of the joint tissue activity and damage examination for quantitation of structural abnormalities by musculoskeletal ultrasound in hemophilic joints.","volume":"38","author":"Volland","year":"2019","journal-title":"J Ultrasound Med"},{"key":"R23-20261102","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1111\/1756-185X.12402","article-title":"Pilot study assessing the novel use of musculoskeletal ultrasound in patients with rheumatoid arthritis to improve patient attitudes and adherence to medication.","volume":"19","author":"Joplin","year":"2016","journal-title":"Int J Rheum Dis"},{"key":"R24-20261102","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/03009742.2021.1901416","article-title":"A musculoskeletal ultrasound program as an intervention to improve disease modifying anti-rheumatic drugs adherence in rheumatoid arthritis: a randomized controlled trial.","volume":"51","author":"Tan","year":"2022","journal-title":"Scand J Rheumatol"},{"key":"R25-20261102","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.2147\/PPA.S99702","article-title":"The impact of using musculoskeletal ultrasound imaging and other influencing factors on medication adherence in patients with rheumatoid arthritis: a qualitative study.","volume":"10","author":"Kumar","year":"2016","journal-title":"Patient Prefer Adherence"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000051155","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T19:01:50Z","timestamp":1793646110000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000051155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":25,"journal-issue":{"issue":"42","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000051155","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"value":"0025-7974","type":"print"},{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"assertion":[{"value":"2024-04-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}