{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:05:28Z","timestamp":1792789528702,"version":"4.5.0"},"reference-count":68,"publisher":"Wiley","issue":"S6","license":[{"start":{"date-parts":[[2018,5,21]],"date-time":"2018-05-21T00:00:00Z","timestamp":1526860800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:p>\n                    Haemarthroses cause major morbidity in patients with haemophilia. Blood has devastating effects on all joint components, resulting in synovitis, osteochondral degeneration and ultimately end\u2010stage haemophilic arthropathy. Key players in this process are iron and inflammation. Preventing joint bleeds is of utmost importance to maintain joint health as targeted therapies directed against blood\u2010induced inflammation and iron\u2010mediated processes are lacking. Joint bleeds result in acute pain as well as chronic pain due to synovitis or arthropathy. Acute pain originates from nociceptors activated by tissue damage. In chronic inflammation, central and peripheral sensitization of nociceptors might occur resulting in chronic pain. This also triggers a series of brain disorders such as emotional fear, anxiety, mood depression and impairment of cognitive functions. Treatment of haemophilia\u2010related pain not only consists of analgesics, but also of exercise, education and in selected cases antidepressants and anticonvulsants. For objective assessment of joint structural outcome and detecting earlier changes of haemophilic arthropathy, both ultrasound (\n                    <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                    ) and magnetic resonance (\n                    <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content>\n                    ) imaging have shown valuable. Both can be considered equally able to reveal signs of disease activity.\n                    <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content>\n                    imaging is able to visualize haemosiderin deposition and is more comprehensive in depicting osteochondral changes. Disadvantages of\n                    <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content>\n                    imaging are the duration of the examination, evaluation of a single joint at a time, costs and may require sedation, and it may need intraarticular contrast injection to depict initial osteochondral changes with accuracy. As such,\n                    <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                    is a more useful screening tool and can be used for repeated follow\u2010up examinations.\n                  <\/jats:p>","DOI":"10.1111\/hae.13449","type":"journal-article","created":{"date-parts":[[2018,5,31]],"date-time":"2018-05-31T18:57:23Z","timestamp":1527793043000},"page":"44-49","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":168,"title":["Joint disease in haemophilia: Pathophysiology, pain and imaging"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3242-5524","authenticated-orcid":false,"given":"L. F. 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