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Symposium #5

The Ankle and Haemophilia: Background, Imaging and Treatment Options

Symposium Chair: Olav Versloot

Background & Relevance: Haemophilia is an X-related, inheritable blood coagulation disorder. Persons with haemophilia (PWH) suffer from low levels of factor VIII (FVIII, haemophilia A) or factor IX (FIX, haemophilia B) coagulation proteins(1). In PWH, repetitive joint trauma and associated bleeds can lead to chronic synovitis and haemophilic arthropathy, which in turn can lead to severe cartilage damage(2), decreased joint function and disability(3). The elbow, knee and particularly the ankle are most frequently affected in PWH(4). The use of prophylaxis in haemophilia has contributed greatly to sport participation of PWH and consequently attributed to the risk of sport related injuries, e.g. in the ankle region. As in recent years, the body of knowledge concerning the pathophysiology, imaging and therapeutic interventions (both conservative and surgical) of ankle involvement in PWH has greatly improved this will be the topic of this symposium. During this symposium, the pathophysiology, imaging possibilities and treatment options, both conservative as well as surgical, of the ankle in PWH will be discussed.

Speaker 1: Olav Versloot

Presentation title: Sports participation and ankle injuries in Dutch children with haemophilia

Speaker 2: Merel Timmer

Presentation title: The application of ultrasound in persons with haemophilia with ankle problems

Speaker 3: Lize van Vulpen

Presentation title: Pathophysiology and surgical treatment of ankle arthropathy in persons with haemophilia

Speaker 4: Nichan Zourikian

Presentation title: Conservative treatment of haemophilia related ankle injuries

1.             Srivastava A, Brewer AK, Mauser-Bunschoten EP, Key NS, Kitchen S, Llinas A, et al. Guidelines for the management of hemophilia. Haemophilia. 2013;19(1):e1–47.
2.             Pulles AE, Mastbergen SC, Schutgens REG, Lafeber FPJG, van Vulpen LFD. Pathophysiology of hemophilic arthropathy and potential targets for therapy. Pharmacol Res [Internet]. 2017;115:192–9. Available from:
3.             Poonnoose PM, Srivastava A. Functional assessment of arthropathy - An international perspective. Semin Hematol. 2006;43(SUPPL. 1).
4.             Stephensen D, Tait R, Brodie N, Collins P, Cheal R, Keeling D, et al. Changing patterns of bleeding in patients with severe haemophilia A. Haemophilia. 2009;15(6):1210–4.