{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:00:17Z","timestamp":1787317217154,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,5,15]],"date-time":"2013-05-15T00:00:00Z","timestamp":1368576000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Little objective information exists about musculoskeletal bleeding patterns in haemophilic arthropathy. Bleeding is assumed to be the cause of painful joints or muscles. Clotting factor treatment is provided empirically, but often does not alleviate pain. We hypothesized that perception of pain aetiology is unreliable, and introduced point\u2010of\u2010care high\u2010resolution musculoskeletal ultrasound (\n                    <jats:styled-content style=\"fixed-case\">MSKUS<\/jats:styled-content>\n                    ) to differentiate intra\u2010articular bleeds vs. joint inflammation, and intra\u2010muscle bleeds vs. other regional pain syndromes. To assess painful musculoskeletal episodes in adult haemophiliacs, we used rapid\n                    <jats:styled-content style=\"fixed-case\">MSKUS<\/jats:styled-content>\n                    , employing grey scale and power Doppler examination. Forty episodes in 30 adult haemophiliacs were evaluated. Thirty three of the 40 episodes were patient\u2010reported as \u2018bleeding\u2019, five as \u2018arthritis\u2010type\u2019 pain and two as \u2018undecided\u2019. Of the 33 bleeding reports, only 12 were confirmed by\n                    <jats:styled-content style=\"fixed-case\">MSKUS<\/jats:styled-content>\n                    ; the other episodes revealed other pathology. In contrast, three of five perceived arthritis flares were reclassified as bleeds. Similarly, physician assessment was incorrect in 18 of 40 instances. Swelling and warmth were present in approximately half of confirmed bleeding and non\u2010bleeding episodes, and therefore not useful clinically. Few of the painful episodes were symptom controlled at the time of\n                    <jats:styled-content style=\"fixed-case\">MSKUS<\/jats:styled-content>\n                    . Management changed based on objective imaging findings in &gt;70% of episodes, which resulted in symptom improvement &gt;60% of the time. Significant discrepancies exist between\n                    <jats:styled-content style=\"fixed-case\">MSKUS<\/jats:styled-content>\n                    findings and patient\/physician\u2010perceived pain classification as bleeding or other musculoskeletal symptoms. Current practice of prescribing clotting factor or conservative measures based on pain perception seems inadequate and suggests that point\u2010of\u2010care imaging should be included into modern haemophilia care.\n                  <\/jats:p>","DOI":"10.1111\/hae.12175","type":"journal-article","created":{"date-parts":[[2013,5,15]],"date-time":"2013-05-15T05:39:03Z","timestamp":1368596343000},"page":"790-798","source":"Crossref","is-referenced-by-count":112,"title":["Rapid musculoskeletal ultrasound for painful episodes in adult haemophilia patients"],"prefix":"10.1111","volume":"19","author":[{"given":"A.","family":"Ceponis","sequence":"first","affiliation":[{"name":"Dept of Medicine, Div of Rheumatology University California San Diego San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Wong\u2010Sefidan","sequence":"additional","affiliation":[{"name":"Dept of Medicine, Div of Hematology\/Oncology University California San Diego San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. S.","family":"Glass","sequence":"additional","affiliation":[{"name":"Dept of Medicine, Div of Hematology\/Oncology University California San Diego San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"von Drygalski","sequence":"additional","affiliation":[{"name":"Dept of Medicine, Div of Hematology\/Oncology University California San Diego San Diego CA USA"},{"name":"Dept of Molecular and Experimental Medicine The Scripps Research Institute La Jolla CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,5,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2012.02834.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2011.02669.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.158.1.1727336"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2011.1.413"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.179.6.1791629"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.09.2841"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0909487"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.11.6798"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21836"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2008.03160.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-006-0319-x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2010.02380.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker433"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.60.7.641"},{"key":"e_1_2_8_16_1","first-page":"2485","article-title":"Musculoskeletal ultrasound including definitions for ultrasonographic pathology","volume":"32","author":"Wakefield RJ","year":"2005","journal-title":"J Rheumatol"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2011.02680.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067659"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2010.02307.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1992.tb00546.x"}],"container-title":["Haemophilia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhae.12175","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.12175","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T09:08:54Z","timestamp":1696324134000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hae.12175"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,15]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2013,9]]}},"alternative-id":["10.1111\/hae.12175"],"URL":"https:\/\/doi.org\/10.1111\/hae.12175","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.727277244.793562061","asserted-by":"object"}]},"ISSN":["1351-8216","1365-2516"],"issn-type":[{"value":"1351-8216","type":"print"},{"value":"1365-2516","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,5,15]]}}}