Joint Bleeds
Bleeding into joints is the most common bleed in older children and adults with a bleeding disorder. Joint bleeding typically begins in the lining of the joint, called synovium. If allowed to continue, the joint space can fill with blood. As this space fills, the pressure causes pain.
The joints affected most often are knees, elbows and ankles. However, bleeds can occur in any joint. When there is bleeding repeatedly into the same joint, that joint is referred to as a “target joint.” Repetitive untreated bleeds can result in permanent damage to that joint.
Signs of a joint bleed
- Complaints of a “tingling" or "bubbling” sensation.
- Decreased voluntary use of a joint.
- Inability or unwillingness to straighten or bend joint as normal (decreased range of motion) There is typically no bruising in a joint bleed. “Favoring” a limb may be the first clue.
- Swelling ranging from slight puffiness to a large, swollen joint.
- Pain usually increases when injury is not detected and treated early.
- When skin over joint feels warm to touch (compared with warmth of joint on opposite side).
Treating joint bleeds
- Treat and repeat with factor as you have been instructed by your hematologist or treatment center.
- Rest the joint initially while the bleed is in progress and the factor stops the bleed.
- Follow RICE protocol while the bleed is resolving.
- Resume movement of the joint as you have been taught. This keeps the muscles around the joint healthy and strong.
- Follow the instructions for prophylactic treatment – this is taking factor before you have a bleed to help prevent it.
Other important points to remember
- Joint bleeding that goes untreated will permanently damage the joint.
- You most likely will not see a bruise with joint bleeding.
- Icing may help with the pain or discomfort. It will not, however, stop the bleeding.
- You need to take you factor as instructed. See RICE.
- Avoid medications that contain aspirin. Talk to your treatment center nurse or physician about alternatives.