{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:14:21Z","timestamp":1790100861114,"version":"4.0.1"},"reference-count":70,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,4,21]],"date-time":"2017-04-21T00:00:00Z","timestamp":1492732800000},"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":[[2017,7]]},"abstract":"<jats:p>Haemophilia is characterized by a spontaneous bleeding tendency, affecting mainly the synovial joints. Recurrent joint bleeds induce a cascade of inflammatory as well as degenerative processes injuring synovium, cartilage and bone. These processes affect each other and may occur in parallel and\/or sequentially. Clinically, the effects of joint bleeds are heterogeneous. A marked variability in joint damage is observed in patients with a similar bleeding history. Also late stage effects differ with some patients developing chronic synovitis, and others suffering from osteochondral degeneration called haemophilic arthropathy. This article reviews the current understanding of the pathogenesis of blood\u2010induced joint damage, elaborates on potential explanations for the differential effects of a bleed, and discusses challenges for future research.<\/jats:p>","DOI":"10.1111\/hae.13236","type":"journal-article","created":{"date-parts":[[2017,4,21]],"date-time":"2017-04-21T06:42:41Z","timestamp":1492756961000},"page":"521-527","source":"Crossref","is-referenced-by-count":45,"title":["Differential effects of bleeds on the development of arthropathy \u2013 basic and applied issues"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3242-5524","authenticated-orcid":false,"given":"L. F. D.","family":"van Vulpen","sequence":"first","affiliation":[{"name":"Van Creveldkliniek University Medical Center Utrecht Utrecht The Netherlands"},{"name":"Department of Rheumatology &amp; Clinical Immunology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. C.","family":"Mastbergen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology &amp; Clinical Immunology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. P. J. G.","family":"Lafeber","sequence":"additional","affiliation":[{"name":"Department of Rheumatology &amp; Clinical Immunology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. E. 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