Arthropathies Associated with Hematologic Diseases
- 1. If a fracture is suspected as a cause of hemarthrosis, evaluate the synovial fluid for fat droplets, which indicates release of bone marrow elements through bony disruption.
- 2. Joint aspiration is generally safe up to an international normalized ratio (INR) of 4.5. However, if septic arthritis is possible, the joint should be aspirated regardless of the INR.
- 3. If a symptomatic joint in a patient with hemophilia does not improve with factor replacement, consider infection.
- 4. Salmonella accounts for 50% of osteomyelitis infections in patients with sickle cell disease (SCD).
- 5. Up to 40% of patients with SCD will experience osteonecrosis of the femoral or humeral head.
