Diagnostic performance of point-of-care ultrasonography (POC-US) in haemophilia joint health: a comparative study with MRI

Introduction Haemophilia presents challenges in joint pathology assessment, prompting exploration of point-of-care ultrasonography (POC-US) as a diagnostic tool. Aims: The study aimed to assess the diagnostic performance of point-of-care ultrasonography (POC-US) compared to magnetic resonance imaging (MRI) in detecting synovial hypertrophy, cartilage abnormality, and bony abnormality among people with haemophilia (PWH) treated at Assam Medical College Hospital. Methods Forty-two PWH underwent POC-US and MRI for joint assessment. The POC-US and MRI imaging interpretation involved calculating diagnostic accuracy parameters for POC-US and MRI scores. This included sensitivity, specificity, positive predictive value, and negative predictive value. Results POC-US demonstrated a sensitivity of around 97% and specificity of 92% for detecting synovial hypertrophy, while showing a sensitivity of 85% and specificity of 100% for bony abnormality. Cartilage abnormality assessment revealed a sensitivity of 55% and specificity of 100%. Knee joint involvement was observed in all patients, with 7% also exhibiting ankle joint pathology. Disease severity distribution showed 57% with severe hemophilia, 24% with moderate, and 19% with mild disease. Conclusion Our study highlights the diagnostic potential of POC-US in haemophilia management, particularly in detecting synovial hypertrophy and bony abnormality. Challenges in assessing cartilage abnormality warrant further investigation. These findings contribute to the discourse on POC-US in haemophilia management, emphasising the need for continued research to elucidate its clinical relevance.