{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T15:09:55Z","timestamp":1769612995550,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,4,2]],"date-time":"2018-04-02T00:00:00Z","timestamp":1522627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009431","name":"Baxalta","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009431","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Patients with haemophilia (PwH) suffer from haemophilic arthropathy which leads to an enhanced pain sensitivity. The aim of this study was to determine whether the individual pain condition in terms of pressure pain thresholds (<jats:styled-content style=\"fixed-case\">PPT<\/jats:styled-content>) at the knee joints is linked to changes of underlying anatomical structures in PwH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Eleven landmarks at both knee joints of 36 PwH and 36 controls were examined in terms of <jats:styled-content style=\"fixed-case\">PPT<\/jats:styled-content> and ultrasound sonography (<jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>). <jats:styled-content style=\"fixed-case\">PPT<\/jats:styled-content> were used to generate four groups: pain sensitive and insensitive knees of PwH and controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">PPT<\/jats:styled-content> of the knee joints were significantly decreased at all landmarks in PwH when compared to controls (<jats:italic>P<\/jats:italic>\u00a0\u2264\u00a0.004). <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> findings revealed that especially osteophytes are more pronounced in pain\u2010sensitive knees of PwH in comparison with pain\u2010insensitive knees of PwH or pain\u2010(in)sensitive knees of controls. The synovia tissue was also thickened in PwH when <jats:styled-content style=\"fixed-case\">PPT<\/jats:styled-content> was altered. In contrast to findings in osteoarthritis\u2010related pain, no differences between the groups were found regarding effusion, whether assessed, for example on the distal edge of m. vastus lateralis (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.893) or on the lateral joint space (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.417).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Particular degenerative changes in terms of osteophytes and thickness of synovial tissue are associated with an enhanced pain sensitivity in PwH. Altered <jats:styled-content style=\"fixed-case\">PPT<\/jats:styled-content> which were not associated with structural findings may be an indicator for a complex peripheral and\/or central sensitization of the affected joints in PwH. The role of this mechanism should be clarified in further studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.13472","type":"journal-article","created":{"date-parts":[[2018,4,2]],"date-time":"2018-04-02T12:25:17Z","timestamp":1522671917000},"page":"657-666","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Pain and structural alterations in knee joints in patients with haemophilia"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1294-3036","authenticated-orcid":false,"given":"S.","family":"Kr\u00fcger","sequence":"first","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal  Wuppertal Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Hoffmeister","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal  Wuppertal Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0935-2526","authenticated-orcid":false,"given":"T.","family":"Hilberg","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal  Wuppertal Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,4,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-08-532820"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2012.02909.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1619823"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2011.02567.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2012.02764.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12023"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2011.02709.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.04.030"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2011.08919.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07386.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2010.02475.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12006"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.10.020"},{"key":"e_1_2_10_15_1","first-page":"99","article-title":"Musculoskeletal ultrasound: technical guidelines. 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