Document Type: CURRENT CONCEPTS REVIEW

Author

Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain

Abstract

Prevention is essential for avoiding the complications of muscle hematomas (pseudotumors, compartment syndromes
and peripheral nerve lesions) in hemophilic patients. This is achieved through early diagnosis of muscle hematomas
and proper long-term hematological treatment until they have resolved (confirmed by image studies). Ultrasound-guided
percutaneous drainage could be beneficial in terms of achieving better and faster symptom relief. When suspecting
a hemophilic pseudotumor, biopsy will help us confirm the diagnosis and rule out true tumors (chondrosarcoma,
liposarcoma, synovial sarcoma) that sometimes mimic hemophilic pseudotumor. Surgical removal of hemophilic
pseudotumor is the best solution. As alternatives, there are curettage and filling with cancellous bone and radiotherapy
(when surgery is contraindicated). Preoperative arterial embolization (ideally 2 weeks before surgery) helps control
intraoperative bleeding during surgery for giant pelvic pseudotumors.
Level of evidence: III

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