{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T10:14:00Z","timestamp":1789812840235,"version":"4.0.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Early identification of synovial hypertrophy is critical for preventing irreversible changes in haemophilic arthropathy (HA). Although prophylaxis has improved joint outcomes, it remains unclear which patients and joints in early HA should be prioritised for musculoskeletal ultrasound (MSKUS) screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To identify the predictors of synovial hypertrophy at the patient and joint levels in early HA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled patients with haemophilia aged 6\u201349\u00a0years with mild joint damage (Arnold\u2013Hilgartner grades I\u2013III). Elbows, knees and ankles were examined using MSKUS. Patient\u2010level factors included age, body mass index, haemophilia characteristics, adherence and activity. Joint\u2010level factors included symptoms, recent bleeding, physical findings and radiographic scores. Logistic regression was applied to patient\u2010level predictors and mixed\u2010effects models to joint\u2010level predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 203 joints from 40 patients were evaluated; synovial hypertrophy was identified in 82 joints (34 patients), most frequently in the knees (54.5%), followed by the elbows (38.9%) and ankles (22.2%). Adult age was the only significant patient\u2010level predictor of synovial hypertrophy (odds ratio, 5.2;\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.001). At the joint level, no examined factors were significantly associated with synovial hypertrophy. Among asymptomatic joints, 37.9% demonstrated synovial hypertrophy (23.7% in paediatric patients vs. 56.9% in adults), with elbow involvement showing no significant age\u2010related differences (34.4% vs. 40.7%,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.79).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patient\u2010 and joint\u2010specific findings alone are insufficient to predict synovial hypertrophy. MSKUS may be used routinely to enhance early detection in patients with HA on prophylaxis. Elbow synovial hypertrophy warrants attention from paediatric patients as one of the earliest stages of the disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70345","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:32:36Z","timestamp":1781843556000},"page":"1255-1263","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Factors for Predicting Synovial Hypertrophy in Early Haemophilic Arthropathy on Prophylaxis: A Cross\u2010Sectional Study of Patient\u2010 and Joint\u2010Level Analyses Using Musculoskeletal Ultrasound"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1783-8355","authenticated-orcid":false,"given":"Takeo","family":"Abe","sequence":"first","affiliation":[{"name":"Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University  Nishinomiya Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Inagaki","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Nara Medical University  Kashihara Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chie","family":"Ogita","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University  Nishinomiya Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Minagawa","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University  Nishinomiya Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taduko","family":"Tokugawa","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Haematology, School of Medicine Hyogo Medical University  Nishinomiya Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Sawada","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Haematology, School of Medicine Hyogo Medical University  Nishinomiya Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Higasa","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Haematology, School of Medicine Hyogo Medical University  Nishinomiya Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitoshi","family":"Ohtsuka","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, School of Medicine Hyogo Medical University  Nishinomiya Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teppei","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University  Nishinomiya Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Azuma","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University  Nishinomiya Hyogo 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