Ultraschall Med 2025; 46(S 01): S15
DOI: 10.1055/s-0045-1812208
Abstracts
Mündliche Beiträge

Pain perception and structural UltraSound findings at ankle joints in patients with Haemophilia (interim results of the PUSH-Study).

Autoren

  • M Sigl-Kraetzig

    1   Institut für pädiatrische Forschung und Weiterbildung / Gerinnungszentrum Süd, Blaubeuren, Deutschland

  • A Schmidt

    2   Bergische Universität, Lehrstuhl für Sportmedizin, Wuppertal, Deutschland

  • F Tomschi

    2   Bergische Universität, Lehrstuhl für Sportmedizin, Wuppertal, Deutschland

  • H Richter

    3   Hämophiliezentrum, Münster, Deutschland

  • T Hilberg

    2   Bergische Universität, Lehrstuhl für Sportmedizin, Wuppertal, Deutschland
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Hintergrund Recurring joint bleedings caused by haemophilia are accompanied by pain. To treat musculoskeletal pain, the understanding of underlying mechanisms and pain inducing structures is crucial. Therefore, the aim of this study was to determine the consequence of structural changes depicted by ultrasound (US) on pain perception, and the sensitivity of pressure pain thresholds (PPT) at the ankle.

Methoden 67 patients with haemophilia A or B (PwH) (severe A=49, B=10; moderate A=8) and 38 healthy controls (Con) were included. A total of 134 ankle joints (AJ) of PwH and 76 of Con were assessed for structural US-findings and pain-related alterations. The HEAD-US-Score was used to determine structural changes of the synovium, cartilage and bone at the tibiotalar joint (TT) and subtalar joint (ST). The landmarks examined by US, were selected to assess the pain situation using PPT. Lower PPT-values indicate an increase in pain sensitivity. To gauge the impact of synovitis and structural damage on pain perception, 3 subgroups were analysed to differentiate:

Group 1 – AJ of PwH with synovitis&damage (AJ-PwH (+/+); Group 2 – AJ of PwH with no synovitis&damage (AJ-PwH (-/-); Group 3 – AJ of Con with no synovitis&damage (AJ-Con (-/-) US-findings.

Ergebnisse One-way ANOVA reveals a group-specific difference for PPT at the TT (N=83 AJ-PwH (+/+)=36.0±15.7, N=41 AJ-PwH (-/-)=57.2±26.3, N=76 AJ-Con (-/-)=70.9±31.3) and at the ST (N=59 AJ-PwH (+/+)=34.5±19.1, N=37 AJ-PwH (-/-)=41.6±20.2, N=76 AJ-Con (-/-)=52.1±26.6; each mean±SD in Newton; each p≤0.001). Post hoc tests revealed significant differences between all groups for the TT (1vs.2, 2vs.3 1vs.3, p≤0.001). For the ST post hoc tests showed a significant difference between 1vs.3, (p≤0.001) and 2vs.3 (p=0.022).

Schlussfolgerung In addition to ultrasound findings data indicates a more sensitized pain perception for PwH compared to Con. This difference in pain perception is particularly eminent. PPT is a specific sensitive measurement tool in detection of functional alterations.


Publikationsverlauf

Artikel online veröffentlicht:
16. Oktober 2025

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