MRINCT07233122
MRI Role in Knee Hemophilic Arthopathy
An observational study of MRI and Hemophilia, run by Assiut University.
Trial summary
The aim of this study is to assess role of MRI in detecting synovial, cartilaginous , osseous abnormalities ، bleeding inside knee joint and to use a system for assessing HA as support for therapeutic regimes and for monitoring response to therapy . Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- MRI, Hemophilia, Arthropathy Hemophilic
- How many people
- 95 participants
- Where
- No sites listed yet
- Study dates
- 1 Dec 2025to 1 Dec 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: The study population will include patients diagnosed with hemophilia A or hemophilia B who are at risk of, or clinically suspected to have, hemophilic arthropathy of the knee joint. Participants will be recruited from hematology and orthopedic clinics. Eligible participants will undergo knee MRI to assess for: Synovial abnormalities (e.g., hypertrophy, hemosiderin deposition) Cartilaginous changes (thinning, erosions) Osseous changes (subchondral cysts, bone erosions, marrow changes) Intra-articular bleeding MRI scoring systems will be applied to quantify disease severity and to evaluate the role of MRI as a tool for supporting therapeutic decisions and monitoring treatment response.
Who may be able to join
- Adult patient ( more than 18 years old ) diagnosed as Haemophilia with history of bleeding in knee joint more than once
Who cannot join
- *contraindications for MRI such as claustrophobia , metallic foriegn body carriers , cardiac pacemaker
- patient refused the exam
- Pregnant female patients
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
kerolos wagdy maurice morid, principal investigator contact
About this study
Official title: MRI Vs Conventional Radiography in Assessing Knee Hemophilic Arthropathy : A Scoring Based Approach
The aim of this study is to assess role of MRI in detecting synovial, cartilaginous , osseous abnormalities ، bleeding inside knee joint and to use a system for assessing HA as support for therapeutic regimes and for monitoring response to therapy .
Read the detailed description
Hemophilia is a mostly inherited genetic disorder caused by a complete or partial deficiency of coagulation factors VIII or IX, which impairs the body's ability to form blood clots-a process necessary to stop bleeding. This results in prolonged bleeding after injury, easy bruising, and an increased risk of internal bleeding, particularly within joints or the brain.
Hemophilic arthropathy (HA), caused by recurrent hemarthrosis, is the most common musculoskeletal manifestation of hemophilia and one of the most disabling complications of the disease. It can lead to severe pain, deformity, destruction of the joint, debilitating arthritis, and permanent joint damage.
Clinical assessment plays only a minor role in detecting the early stages of HA, as early clinical signs are often nonspecific and of limited value in quantifying disease involvement. Conventional radiographs mainly detect bone lesions that appear in advanced HA, but they cannot identify early changes such as synovial hypertrophy or focal cartilage destruction. Computed tomography (CT) is highly sensitive for detecting bone changes, but it provides limited information on soft tissue involvement and requires a relatively high dose of ionizing radiation.
By contrast, magnetic resonance imaging (MRI) offers superior soft tissue contrast, allowing detailed evaluation of hemophilic joints and visualization of synovial and cartilaginous abnormalities.
T1-weighted imaging: evaluates bone marrow, joint anatomy, and subchondral changes.
T2 fat-suppressed imaging: useful for detecting synovitis and joint effusion.
Gradient echo (GRE) or susceptibility-weighted imaging (SWI): detect chronic blood products (hemosiderin), with SWI being more sensitive and able to identify earlier blood deposits.
Several scoring systems exist for the assessment of hemophilic arthropathy, including the European scoring system and the International Prophylaxis Study Group (IPSG) MRI scale. The IPSG system provides more detailed scoring and greater sensitivity for early disease, including subtle synovial changes. For radiographs, the most widely used system is the Pettersson radiographic scoring system.
In this study, the investigators will use the IPSG MRI scoring system and the Pettersson X-ray scoring system to evaluate hemophilic arthropathy, with the aim of improving grading, management, and follow-up.
- Conditions
- MRI, Hemophilia, Arthropathy Hemophilic, Arthropathy of Knee
- Medical subject headings
- Hemophilia A
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| MRI in Knee Hemophilic Arthopathy | Participants diagnosed with hemophilia and clinical suspicion of knee arthropathy will undergo magnetic resonance imaging (MRI) of the affected knee. MRI will be performed using standardized sequences to evaluate joint changes, including synovial hypertrophy, hemosiderin deposition, cartilage thinning, and bone damage. Findings will be scored using the International Prophylaxis Study Group (IPSG) MRI scoring system. | |
| Xray in Knee Hemophilic Arthropathy | Participants diagnosed with hemophilia and clinical suspicion of knee arthropathy will undergo conventional radiography (X-ray) of the affected knee. Standard anteroposterior and lateral views will be obtained to evaluate joint changes, including joint space narrowing, osteoporosis, subchondral cysts, erosions, and bone deformities. Findings will be scored using the Pettersson X-ray scoring system. |
What is being measured
The primary outcome is the main question the study is designed to answer.
International Prophylaxis Study Group (IPSG) MRI Score for Hemophilic Arthropathy
Assessment of knee hemophilic arthropathy severity using the International Prophylaxis Study Group (IPSG) MRI scoring system. This scoring system evaluates early and advanced joint changes such as synovial hypertrophy, hemosiderin deposition, and cartilage/bone damage.
Measured: After completion of MRI scanning session (within the same study visit). Overall Study Duration: 2 years (for recruitment, imaging, and data analysis).
Secondary outcomes (2)
Pettersson X-ray Score for Hemophilic Arthropathy
Assessment of knee hemophilic arthropathy severity using the Pettersson X-ray scoring system. This system evaluates joint space narrowing, osteoporosis, subchondral cysts, erosions, and bone deformities to quantify the degree of arthropathy.
Measured: After completion of X-ray scanning session (within the same study visit). Overall Study Duration: 2 years (including recruitment, imaging, and data analysis).
Agreement Between MRI and X-ray Scoring Systems in Hemophilic Arthropathy
To evaluate the agreement between the International Prophylaxis Study Group (IPSG) MRI score and the Pettersson X-ray score in assessing the severity of knee hemophilic arthropathy. This outcome will determine the level of concordance between the two imaging modalities in detecting joint changes.
Measured: After completion of MRI and X-ray scanning sessions (within the same study visit). Overall study duration: 2 years (including recruitment, imaging, and data analysis).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Nov 2025
- Study start1 Dec 2025 (estimated)
- Primary completion1 Dec 2027 (estimated)
- Study completion1 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for MRIStudies of the same condition, open and under way.
- More trials run by Assiut UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Cross-sectional
- Enrolment
- 95 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Assiut University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, kerolos wagdy maurice morid, Assiut University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07233122
- Sponsor's protocol ID
- MRI in Hemophilic Arthopathy
- Status last verified
- Nov 2025
- First submitted
- 19 Sep 2025
- Last updated
- 18 Nov 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Ibad HA, de Cesar Netto C, Shakoor D, Sisniega A, Liu SZ, Siewerdsen JH, Carrino JA, Zbijewski W, Demehri S. Computed Tomography: State-of-the-Art Advancements in Musculoskeletal Imaging. Invest Radiol. 2023 Jan 1;58(1):99-110. doi: 10.1097/RLI.0000000000000908. Epub 2022 Aug 16.
PubMed 35976763Foppen W, van der Schaaf IC, Beek FJA, Mali WPTM, Fischer K. MRI predicts 5-year joint bleeding and development of arthropathy on radiographs in hemophilia. Blood Adv. 2020 Jan 14;4(1):113-121. doi: 10.1182/bloodadvances.2019001238.
PubMed 31917842Lundin B, Manco-Johnson ML, Ignas DM, Moineddin R, Blanchette VS, Dunn AL, Gibikote SV, Keshava SN, Ljung R, Manco-Johnson MJ, Miller SF, Rivard GE, Doria AS; International Prophylaxis Study Group. An MRI scale for assessment of haemophilic arthropathy from the International Prophylaxis Study Group. Haemophilia. 2012 Nov;18(6):962-70. doi: 10.1111/j.1365-2516.2012.02883.x. Epub 2012 Jul 5.
PubMed 22765835Haacke EM, Mittal S, Wu Z, Neelavalli J, Cheng YC. Susceptibility-weighted imaging: technical aspects and clinical applications, part 1. AJNR Am J Neuroradiol. 2009 Jan;30(1):19-30. doi: 10.3174/ajnr.A1400. Epub 2008 Nov 27.
PubMed 19039041Kim HK, Zbojniewicz AM, Merrow AC, Cheon JE, Kim IO, Emery KH. MR findings of synovial disease in children and young adults: Part 1. Pediatr Radiol. 2011 Apr;41(4):495-511; quiz 545-6. doi: 10.1007/s00247-011-1971-0. Epub 2011 Feb 22.
PubMed 21337125
Study at a glance
From the registry record, last updated by the sponsor on 18 Nov 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- MRI Vs Conventional Radiography in Assessing Knee Hemophilic Arthropathy : A Scoring Based Approach
- ClinicalTrials.gov ID
- NCT07233122
- Acronym / sponsor ID
- MRI in Hemophilic Arthopathy
- Conditions
- MRI, Hemophilia, Arthropathy Hemophilic, Arthropathy of Knee
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 95 participants (estimated)
- Lead sponsor
- Assiut UniversityUniversity, hospital or other
- Study start
- 1 Dec 2025 (estimated)
- Primary completion
- 1 Dec 2027 (estimated)
- Study completion
- 1 Dec 2027 (estimated)
- First posted
- 18 Nov 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this study is to assess role of MRI in detecting synovial, cartilaginous , osseous abnormalities ، bleeding inside knee joint and to use a system for assessing HA as support for therapeutic regimes and for monitoring response to therapy .
Detailed description
Hemophilia is a mostly inherited genetic disorder caused by a complete or partial deficiency of coagulation factors VIII or IX, which impairs the body's ability to form blood clots-a process necessary to stop bleeding. This results in prolonged bleeding after injury, easy bruising, and an increased risk of internal bleeding, particularly within joints or the brain.
Hemophilic arthropathy (HA), caused by recurrent hemarthrosis, is the most common musculoskeletal manifestation of hemophilia and one of the most disabling complications of the disease. It can lead to severe pain, deformity, destruction of the joint, debilitating arthritis, and permanent joint damage.
Clinical assessment plays only a minor role in detecting the early stages of HA, as early clinical signs are often nonspecific and of limited value in quantifying disease involvement. Conventional radiographs mainly detect bone lesions that appear in advanced HA, but they cannot identify early changes such as synovial hypertrophy or focal cartilage destruction. Computed tomography (CT) is highly sensitive for detecting bone changes, but it provides limited information on soft tissue involvement and requires a relatively high dose of ionizing radiation.
By contrast, magnetic resonance imaging (MRI) offers superior soft tissue contrast, allowing detailed evaluation of hemophilic joints and visualization of synovial and cartilaginous abnormalities.
T1-weighted imaging: evaluates bone marrow, joint anatomy, and subchondral changes.
T2 fat-suppressed imaging: useful for detecting synovitis and joint effusion.
Gradient echo (GRE) or susceptibility-weighted imaging (SWI): detect chronic blood products (hemosiderin), with SWI being more sensitive and able to identify earlier blood deposits.
Several scoring systems exist for the assessment of hemophilic arthropathy, including the European scoring system and the International Prophylaxis Study Group (IPSG) MRI scale. The IPSG system provides more detailed scoring and greater sensitivity for early disease, including subtle synovial changes. For radiographs, the most widely used system is the Pettersson radiographic scoring system.
In this study, the investigators will use the IPSG MRI scoring system and the Pettersson X-ray scoring system to evaluate hemophilic arthropathy, with the aim of improving grading, management, and follow-up.
Study design
- Observational model
- Other
- Time perspective
- Cross-sectional
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| MRI in Knee Hemophilic Arthopathy | – | –Participants diagnosed with hemophilia and clinical suspicion of knee arthropathy will undergo magnetic resonance imaging (MRI) of the affected knee. MRI will be performed using standardized sequences to evaluate joint changes, including synovial hypertrophy, hemosiderin deposition, cartilage thinning, and bone damage. Findings will be scored using the International Prophylaxis Study Group (IPSG) MRI scoring system. |
| Xray in Knee Hemophilic Arthropathy | – | –Participants diagnosed with hemophilia and clinical suspicion of knee arthropathy will undergo conventional radiography (X-ray) of the affected knee. Standard anteroposterior and lateral views will be obtained to evaluate joint changes, including joint space narrowing, osteoporosis, subchondral cysts, erosions, and bone deformities. Findings will be scored using the Pettersson X-ray scoring system. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- The study population will include patients diagnosed with hemophilia A or hemophilia B who are at risk of, or clinically suspected to have, hemophilic arthropathy of the knee joint. Participants will be recruited from hematology and orthopedic clinics. Eligible participants will undergo knee MRI to assess for: Synovial abnormalities (e.g., hypertrophy, hemosiderin deposition) Cartilaginous changes (thinning, erosions) Osseous changes (subchondral cysts, bone erosions, marrow changes) Intra-articular bleeding MRI scoring systems will be applied to quantify disease severity and to evaluate the role of MRI as a tool for supporting therapeutic decisions and monitoring treatment response.
Key inclusion criteria (1 listed)
- Adult patient ( more than 18 years old ) diagnosed as Haemophilia with history of bleeding in knee joint more than once
Key exclusion criteria (3 listed)
- *contraindications for MRI such as claustrophobia , metallic foriegn body carriers , cardiac pacemaker
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
International Prophylaxis Study Group (IPSG) MRI Score for Hemophilic Arthropathy
Time frame: After completion of MRI scanning session (within the same study visit). Overall Study Duration: 2 years (for recruitment, imaging, and data analysis).
Assessment of knee hemophilic arthropathy severity using the International Prophylaxis Study Group (IPSG) MRI scoring system. This scoring system evaluates early and advanced joint changes such as synovial hypertrophy, hemosiderin deposition, and cartilage/bone damage.
2 secondary outcomes
Pettersson X-ray Score for Hemophilic Arthropathy
Time frame: After completion of X-ray scanning session (within the same study visit). Overall Study Duration: 2 years (including recruitment, imaging, and data analysis).
Agreement Between MRI and X-ray Scoring Systems in Hemophilic Arthropathy
Time frame: After completion of MRI and X-ray scanning sessions (within the same study visit). Overall study duration: 2 years (including recruitment, imaging, and data analysis).
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Nov 2025.
- Results publication: PubMed 35976763Ibad HA, de Cesar Netto C, Shakoor D, Sisniega A, Liu SZ, Siewerdsen JH, Carrino JA, Zbijewski W, Demehri S. Computed Tomography: State-of-the-Art Advancements in Musculoskeletal Imaging. Invest Radiol. 2023 Jan 1;58(1):99-110. doi: 10.1097/RLI.0000000000000908. Epub 2022 Aug 16.
- Results publication: PubMed 31917842Foppen W, van der Schaaf IC, Beek FJA, Mali WPTM, Fischer K. MRI predicts 5-year joint bleeding and development of arthropathy on radiographs in hemophilia. Blood Adv. 2020 Jan 14;4(1):113-121. doi: 10.1182/bloodadvances.2019001238.
- Results publication: PubMed 22765835Lundin B, Manco-Johnson ML, Ignas DM, Moineddin R, Blanchette VS, Dunn AL, Gibikote SV, Keshava SN, Ljung R, Manco-Johnson MJ, Miller SF, Rivard GE, Doria AS; International Prophylaxis Study Group. An MRI scale for assessment of haemophilic arthropathy from the International Prophylaxis Study Group. Haemophilia. 2012 Nov;18(6):962-70. doi: 10.1111/j.1365-2516.2012.02883.x. Epub 2012 Jul 5.
- Results publication: PubMed 19039041Haacke EM, Mittal S, Wu Z, Neelavalli J, Cheng YC. Susceptibility-weighted imaging: technical aspects and clinical applications, part 1. AJNR Am J Neuroradiol. 2009 Jan;30(1):19-30. doi: 10.3174/ajnr.A1400. Epub 2008 Nov 27.
- Results publication: PubMed 21337125Kim HK, Zbojniewicz AM, Merrow AC, Cheon JE, Kim IO, Emery KH. MR findings of synovial disease in children and young adults: Part 1. Pediatr Radiol. 2011 Apr;41(4):495-511; quiz 545-6. doi: 10.1007/s00247-011-1971-0. Epub 2011 Feb 22.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
kerolos wagdy maurice morid, principal investigator contact
Questions about this trial
What is this clinical trial studying?
An observational study of MRI and Hemophilia, run by Assiut University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 18 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact kerolos wagdy maurice morid, principal investigator (+201062053217, Cerles.17289725@med.aun.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
International Prophylaxis Study Group (IPSG) MRI Score for Hemophilic Arthropathy (time frame: After completion of MRI scanning session (within the same study visit). Overall Study Duration: 2 years (for recruitment, imaging, and data analysis).). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07233122, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Nov 2025.