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Joint bleeds in hemophilia


What is a joint bleed?

  • It is the most common type of bleed for patients with hemophilia.
  • Most common joints involved: knees, ankles, elbows, with half of all joint bleeds occurring in knees
  • Most common “target joint” is the knee. When a spontaneous untreated joint bleed occurs often, that is a “target joint” bleed.
  • Even one poorly treated bleed can cause changes in the joint or enough damage to create a target joint.

What are the signs and symptoms of a joint bleed?

Early signs and symptoms of a joint bleed

  • Pain, bubbling, tingling, heat
  • Swelling and pain increasing as bleeding progresses
  • Usually no visible bruising
  • Patient does not want to move
  • Patient holds affected limb in “flexed position” or bent

Late signs and symptoms of a joint bleed

  • Pain, swelling, heat
  • Synovitis (pain and swelling in certain joints because of extra fluid)
  • Joint destruction that can cause muscle wasting
  • Stiff, chronic pain
  • Limited mobility

How should I treat a joint bleed?

  • Always treat with your factor right away if you suspect a joint bleed.
  • Use a tape measure and measure both the affected joint and the non-affected joint to compare size, shape, temperature, and pain. Measure at the largest point of swelling.
  • Call your hemophilia treatment center and report the bleed. Always follow the “Joint Protocol” in your treatment plan for any joint bleed.
  • Use R.I.C.E. (rest, ice, compression, elevate). Remember to stay off the joint until the pain and swelling improves.

Normal knee joint

Normal knee joint

Pictures courtesy of World Federation of Hemophilia

Sensations felt in a knee joint bleed

The joint becomes swollen and more painful as the bleed continues, sometimes causing damage to the cartilage (flexible tissue that connects bones together at the joints).

Early and late sensation in knee joint bleed
Synovitis and joint destruction from a knee joint bleed


If you have questions or concerns about joint bleeds, please call the Hematology Clinic at 901-595-5041. If you are calling after hours or on the weekend, dial 901-595-3300 and ask for the nursing coordinator or the doctor on call. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833) and press 0 when the call connects.

Pictures courtesy of World Federation of Hemophilia


This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).

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