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Arthrocentesis confirmed the diagnosis and provided relief from symptoms. This case describes a rare bleeding complication following TNK therapy and adds to the limited literature on atypical extracranial bleeding after thrombolysis. It emphasises the need to consider such presentations during post-thrombolysis monitoring.<\/jats:p>","DOI":"10.1136\/bcr-2026-273429","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T11:25:12Z","timestamp":1786361112000},"page":"e273429","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Spontaneous haemarthrosis after tenecteplase administration for acute ischaemic stroke"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4320-5534","authenticated-orcid":false,"given":"Rachel","family":"Goldstein","sequence":"first","affiliation":[{"name":"School of Medicine, UMass Chan Medical School, Worcester, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil","family":"Menashe","sequence":"additional","affiliation":[{"name":"Psychiatry-Neurology, UMass Chan Medical School, Worcester, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"2026081004250749000_19.8.e273429.1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15444"},{"key":"2026081004250749000_19.8.e273429.2","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.joca.2020.11.008","article-title":"Blood in the joint: effects of hemarthrosis on meniscus health and repair techniques","volume":"29","author":"Lyons","year":"2021","journal-title":"Osteoarthr Cartil"},{"key":"2026081004250749000_19.8.e273429.3","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000211"},{"key":"2026081004250749000_19.8.e273429.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60584-5"},{"key":"2026081004250749000_19.8.e273429.5","first-page":"271","article-title":"Spontaneous hemarthrosis as a hemorrhagic complication after thrombolytic treatment","volume":"40","author":"Birnbaum","year":"1993","journal-title":"Int J Cardiol"},{"key":"2026081004250749000_19.8.e273429.6","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1016\/j.jacc.2025.07.061","article-title":"Fibrinolytic Therapy for Thromboembolic Diseases: Approved Indications and Future Directions","volume":"86","author":"Rashedi","year":"2025","journal-title":"J Am Coll Cardiol"},{"key":"2026081004250749000_19.8.e273429.7","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000154872.73240.e9"},{"key":"2026081004250749000_19.8.e273429.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1109842"},{"key":"2026081004250749000_19.8.e273429.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1716405"},{"key":"2026081004250749000_19.8.e273429.10","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30253-3"},{"key":"2026081004250749000_19.8.e273429.11","doi-asserted-by":"crossref","unstructured":"Prabhakaran S , Gonzalez NR , Zachrison KS , et al . 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association\/American Stroke Association. 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