Acute hemarthrosis in severe hemophilia is treated with factor concentrate FIRST — within minutes — before imaging or analgesia, to limit joint damage. With known factor VIII inhibitor, bypassing agents (FEIBA or recombinant factor VIIa) are used because additional factor VIII will be neutralized. RICE (rest, ice, compression, elevation) follows factor replacement. Heat increases bleeding. Aspiration is avoided in routine hemarthrosis. Aspirin and NSAIDs inhibit platelets and worsen bleeding — acetaminophen is preferred for analgesia.
Clinical scenario
Knee swollen, warm, decreased range of motion. No external bleeding. Has factor VIII inhibitor history. Last factor replacement 2 weeks ago.
For study reference only. Always follow current clinical guidelines and your institution’s protocols.