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What is hemarthrosis?

Hemarthrosis is bleeding into a joint, usually after an injury. Blood vessels inside the joint are damaged and bleed. The blood then collects in the joint space. The shoulder and knee joints are most commonly affected. Elbow, ankle, and hip joints may also be affected.

What increases my risk for hemarthrosis?

  • Hemophilia or other blood disorder
  • Blood thinner medicine
  • A tumor, neuropathy, or myelopathy
  • Osteoarthritis or septic arthritis
  • Arthroplasty (surgery) on your knee joint
  • Cartilage or vascular damage
  • Sickle cell disease or scurvy

What are the signs and symptoms of hemarthrosis?

  • Warmth or tingling in the joint
  • Joint pain or swelling
  • Red skin over the affected joint
  • Trouble moving the joint, or joint stiffness

How is hemarthrosis diagnosed?

Your healthcare provider will examine your affected joint. Tell him about your symptoms and when they started. He will ask about any medical conditions you have, such as hemophilia. Tell him if your joint was injured or if you had a recent knee arthroplasty. Also tell him if you are taking blood thinner medicine. You may also need any of the following:

  • Aspiration is a procedure used to take fluid from the joint to be tested for blood. This procedure is also called arthrocentesis. Your healthcare provider may also use aspiration to treat your hemarthrosis.
  • MRI or ultrasound pictures may show joint damage or other problems. Do not enter the MRI room with anything metal. Metal can cause serious damage. Tell the healthcare provider if you have any metal in or on your body.

How is hemarthrosis treated?

  • Rest may help stop the bleeding. Your healthcare provider may also want you to use crutches or a sling to help rest the affected joint. He may recommend that you limit the amount of time you rest the joint. Long periods without movement can cause problems such as muscle contracture (shortening).
  • Medicines may be given to improve clotting if you have hemophilia. If your hemarthrosis was caused by blood thinners, your healthcare provider may change your dose. He may have you stop using them until your blood clotting ability improves. Do not stop taking your medicine unless directed. A sudden stop can be life-threatening.
  • Surgery may be used to remove lining from the joint, or bone from near the affected joint.
  • Joint replacement may be needed if other treatments do not work. All or part of the joint is replaced with an artificial piece during surgery.

What can I do to manage hemarthrosis?

  • Ask about medicines. Talk to your healthcare provider about all medicines you currently take. Do not take any medicine, vitamin, or supplement without talking to your healthcare provider. Ask if it is safe for you to take aspirin. Aspirin can affect blood clotting.
  • Return to activities as directed. You may need to wait until your joint is rested or medicines are working. Ask if it is safe for you to play sports, such as football, that can cause injury or bleeding. Sports can be especially dangerous if you have hemophilia.
  • Go to physical therapy as directed. Your healthcare provider may also recommend that you work with a physical therapist if you have joint damage from hemarthrosis. A physical therapist can help improve your joint's range of motion.
  • Exercise as directed. Exercise helps strengthen muscles and keeps joints healthy. Strong muscles also help protect joints. Your healthcare provider may recommend exercise such as swimming, walking, or riding a bicycle. Ask how much exercise you need and which exercises are best for you.
  • Apply ice to the joint as directed. Ice helps reduce pain and swelling. Ice can also help prevent tissue damage. Use an ice pack, or put ice in a plastic bag and cover it with a towel. Place the ice pack or bag on the affected joint for 15 minutes every hour, or as directed.

When should I seek immediate care?

  • You have new or worsening joint pain.
  • You have joint pain that moves to a muscle or other area.
  • You cannot move the joint.

When should I contact my healthcare provider?

  • You have pain that does not get better after you take your pain medicine.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.