Purpose or Case Report: Hemophilia is an inherited bleeding disorder occurring mainly in males. Bleeding in these patients may occur acutely in different and unusual locations throughout the body, sometimes with life-threatening consequences. Repeated bleeding episodes may cause chronic manifestations, frequently resulting in severe morbidity to the patient.

The most common manifestation of the disease is acute hemorrhage into joints causing hemarthrosis. This usually affects large joints such as the knee, elbow, ankle, hip and shoulder. Repeated episodes can lead to pannus formation with destruction of the synovium, cartilage and subchondral bone resulting in a condition known as hemophilic arthropathy. In the long term, this may result in debilitating chronic pain and contractures.

Soft tissue hematomas are another frequent manifestation of the disease. Chronic, organized hematomas are also known as hemophilic pseudotumours. These lesions may become calcified or infected and may result in bone erosion with pathological fractures.

Bleeding may occur in other parts of the body such as the brain and spine causing acute stroke with subsequent seizures and neurological deficits. Intra-abdominal bleeding into the abdominal cavities and intramural bleeding into the genitourinary or gastrointestinal walls may rarely occur. It is hence important for radiologists and clinicians to recognize these complications in order to detect and treat these conditions in a timely manner.

The aim of this exhibit is to familiarize readers with the imaging features of acute and chronic bleeding complications in hemophilia patients, highlighting unusual locations in the body where these can occur, using multimodality imaging i.e. Plain radiographs, ultrasound, CT and MRI.
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