REFARAT

HEMARTHROSIS

Oleh
Anshari Samad
10542036712

Pembimbing: dr. Hj. Ramlah Massing, Sp.Rad

introduction

 Hemarthrosis is a complex disease in which bleeding occurs

into the joint cavity. Usually, it is caused by trauma to the joint,
resulting in the rupture of blood vessels that supply blood. The
most common hemarthrosis is from the knee joint, in lesser cases
the clinical development of hemarthrosis is also on the elbows,
hips and shoulders.
Anatomi Sendi
 Genu joint/knee joint
 Elbow Joint
 Wrist Joint
 Angkle Joint
 Hip Joint
Defenisi
 Hemarthrosis bleeding at the joint often seen in
acute injuries in which a tear in the vascular
structure occurs.
Etiologi

 Trauma

 Non Trauma
Clasification
Acute Hemartrosis
Acute haemartrosis occurs rapidly after
prodromal symptoms of pain and stiffness. The
joints become tense, swollen, hard, hot and
painful, while the skin on top is shiny and red.
The affected joint is always in a position of
flexion and limited movement due to
hemarthrosis and pain. The pain quickly
disappears
Subacute hemarthrosis
Subacute hemarthrosis occurs after two or
more acute hemarthrosis, despite
adequate therapy. Sinovium thickens and
there is a moderate restriction in joint
movement. Pain is not a major symptom of
this subacute stage
 Chronic hemartrosis
Chronic hemarthrosis occurs after subacute hemarthrosis
lasts for 6 months or more. Progressive changes occur
until the late stages of arthropathy are a state of
fibrosis, contractures, due to extensive joint damage.
Stage 1
Stage 2
Stage 3
Stage 4
Stage 5
Clinical Symptoms
 Pain

 Swollen

 Limited movement of joints

 Stiff pain is exacerbated by movement

 Looks of bruises on the affected joint area

Radiologi Image
 X-Ray

Ada fraktur kominatif yang melibatkan patel a dengan pemisahan fragmen fraktur.
Ada hemarthrosis suprapatel ar kecil
 Pada X-ray Ankle Join lateral pergelangan kaki ini menunjukkan
lusen lemak normal di anterior sendi tibiotalar yang digantikan oleh
kerapatan jaringan lunak ovoid (panah putih) yang mewakili cairan di
bagian inferior dari reses anterior. Tanda panah kuning menunjukkan
kepadatan jaringan lunak lobular yang meluas ke posterior dari sendi
pergelangan kaki dan anterior lain (panah putih). Dan nampak
hemarthrosis.
 CT Scan

CT scan menunjukkan hemarthrosis sendi lutut, potongan aksial.

Pemindaian menunjukkan efusi darah (merah) di bawah patella.
 MRI

Hematoma sumsum fokal dan perdarahan intraartikular. Suprapatellar reses

tersegmentasi oleh plak suprapatellar non-perforasi (septum completum
Management therapy
 Management in hemarthrosis usually depends on
clinical manifestations / primary factors
 If there is a large hemarthrosis sterile aspiration,
before 24 hours
 As an initial treatment can be done ice packs on the
affected joints for 15 minutes every 1-2 hours
during the first 48 hours
Differential Diagnosis
Hemofilia
 Hemophilia is the first known and widely known congenital
blood disorder disease since 1911. At that time hemophilia
was known as a result of a congenital blood clotting disorder
inherited by a healthy woman.
ACL
 An ACL injury (anterior cruciate ligament) or ACL rupture is a
tear in one of the knees that connects the upper leg bone with
the lower leg bone where the ACL maintains knee stability

Fraktur daerah Intercondylar. Berupa fraktur avulsion (panah merah dan putih)
pada interkondylar. Ada juga hemarthrosis suprapatellar besar (panah kuning).
Fraktur semacam itu terkait dengan cedera pada ligamen anterior cruciatum
Artritis Septik
 septic arthritis is an infection of the joint cavity and is usually a bacterial
infection. Septic arthriris is the most dangerous form of acute arthritis, and is
an emergency orthopedic case.

Foto pelvis AP Tampak proses destruksi pada permukaan sendi hip kiri. (kanan)
MRI potongan sagital pasien septic arthritis pada sendi lutut kiri, tampak efusi
sendi, synovial thickening dan subcutaneous edem
Miositis Ossificans
 also known as heterophysical hardening or ectopic hardening are
pathologic bone formation that occurs in soft tissues that usually do not have
hardening

Area opasitas radio padat muncul seperti 'selubung' yang tercatat di sisi kanan
bersebelahan dengan femur.

Tampak lebih padat daripada tulang dengan margin tidak beraturan dan terlihat
terbentuk sepanjang sumbu panjang (sejajar) dengan tulang
Hemangioma
Hemangioma is an abnormal proliferation of blood vessels that can occur in any
jaingan containing blood vessels. Thus, hemangiomas can occur in the cuticle, subcutis,
muscle, liver, gastrointestinal tract, brain, lung, or bone

Penebalan kortek tulang akibat hemangioma intramuscular pada betis38

Gambran yang ditunjukan dapat berupa bayangan masa yang isodens dengan otot,
bila didekat tulang dapat memberikan gambranperiosteal reaction
Hematoma
 Hematoma is a collection (blood collection) outside

the blood vessels. Hematomas occur because the walls

of blood vessels, arteries, veins or capillaries, have
been damaged and blood has leaked into the tissues
where it is out of place.

MRI namapak
perdarahan pada otot
akibat Cedera otot
betis bertahan 2
minggu
lalu.intramuscularhem
atoma(hyperintens)
Tinjauan keislaman

 Tiap-tiap yang berjiwa akan merasakan mati. Kami

akan mengujimu dengan keburukan dan
kebaikansebagai cobaan (yang sebenar-benarnya).
Dan hanya kepada Kami-lah kamu
dikembalikan.” (QS. al-Anbiyaa’: 35).
THANKS