Related Experiment Video
Updated: Apr 12, 2026
A Novel Application of Musculoskeletal Ultrasound Imaging
Published on: September 17, 2013
Assessment of Musculoskeletal Function and its Correlation with Radiological Joint Score in Children with Hemophilia
Samriti Gupta1,2, Kapil Garg3, Jagdish Singh3
1Department of Pediatric Medicine, S.M.S. Medical College, Jaipur, India. docsam03.samriti@gmail.com.
Insights
Functional Independence Score in Hemophilia (FISH) and Pettersson scores effectively assess joint health in children with hemophilia A. These tools correlate well, aiding clinical practice when MRI is unavailable.
Area of Science:
- Pediatric Hematology
- Orthopedics
- Radiology
Background:
- Hemophilia A significantly impacts children's musculoskeletal function and joint health.
- Assessing functional independence and joint damage is crucial for managing hemophilia A.
Purpose of the Study:
- To evaluate functional independence in children with hemophilia A.
- To correlate functional independence with radiological joint scores.
Main Methods:
- Cross-sectional study of 98 children (4-18 years) with hemophilia A.
- Functional independence assessed using the Functional Independence Score in Hemophilia (FISH).
- Radiological joint assessment using the Pettersson score on plain X-rays.
Main Results:
- Mean FISH score was 28.07, with squatting, running, and step climbing most affected.
- Mean Pettersson score was 3.8.
- Significant negative correlation between Pettersson and FISH scores (r=-0.875, P<0.001), particularly for knee and elbow joints.
Conclusions:
- FISH and Pettersson scores are valuable clinical tools for hemophilia A assessment, especially when MRI is inaccessible.
- FISH is a reliable measure of functional independence in children with hemophilia A.
- Radiological joint assessment complements functional evaluation in hemophilia A management.
Objective:
To evaluate the functional independence of children with hemophilia A and its correlation to radiological joint score.
Methods:
The present cross sectional study was conducted at SPMCHI, SMS Medical College, Jaipur, India. Children in the age group of 4-18 y affected with severe, moderate and mild hemophilia A and with a history of hemarthrosis who attended the OPD, emergency or got admitted in wards of SPMCHI, SMS Medical College were examined. Musculoskeletal function was measured in 98 patients using Functional Independence Score in Hemophilia (FISH) and index joints (joints most commonly affected with repeated bleeding) were assessed radiologically with plain X rays using Pettersson score.
Results:
The mean FISH score was 28.07 ± 3.90 (range 17-32) with squatting, running and step climbing as most affected tasks. The mean Pettersson score was 3.8 ± 3.2. A significant correlation was found between mean Pettersson score and FISH (r = -0.875, P < 0.001) with knee and elbow having r = -0.810 and -0.861 respectively, but not in case of ankle with r = -0.420 (P 0.174).
Conclusions:
The FISH and radiological joint (Pettersson's) scores may be extremely useful in the clinical practice in the absence of magnetic resonance imaging (MRI), which is considered very sensitive to detect early joint damage, but at a cost that makes it relatively inaccessible. FISH seems to be a reliable tool for assessment of functional independence in patients with hemophilia A.
