This composite of five diagnostic X-ray radiographs demonstrates severe, bilateral haemophilic arthropathy in a patient scheduled for total knee arthroplasty (TKA). Panels A and C show anteroposterior (AP) views of the right and left knees, respectively, revealing advanced tricompartmental degeneration characterized by severe, asymmetric joint space narrowing, subchondral sclerosis, and significant marginal osteophyte formation. Irregularity of the articular surfaces and squaring of the femoral condyles, typical of chronic hemarthrosis-related damage, are present. Panels B and D provide lateral views, highlighting anterior osteophytes, patellofemoral joint space loss, and posterior subluxation tendencies. Panel E is a full-length, weight-bearing standing AP radiograph of the lower limbs and pelvis, which visualizes the global alignment and mechanical axes. It confirms the symmetric severity of the knee pathology and allows for the assessment of lower limb deformities, such as valgus or varus malalignment, occurring secondary to the extensive articular cartilage and bone destruction. This imaging series illustrates the end-stage clinical manifestations of haemophilic joint disease.

This composite of diagnostic X-ray radiographs documents a total hip replacement (THR) procedure in a patient with haemophilia. Panel (a) shows a preoperative anteroposterior view of the pelvis, revealing significant narrowing of the left hip joint space and altered morphology of the femoral head consistent with advanced haemophilic arthropathy or secondary osteoarthritis. Panel (b) provides a lateral preoperative view focusing on the left hip, highlighting the degenerative changes and bony remodeling. Panel (c) is a postoperative radiograph demonstrating the successful implantation of a total hip prosthesis. The image displays a highly radio-opaque metallic femoral stem anchored within the femoral canal, a spherical femoral head component, and an acetabular cup with visible marker wires. The alignment of the prosthetic components restores the joint space and structural integrity of the hip. This educational series illustrates the transition from severe joint pathology to surgical reconstruction in the context of specialized orthopedic management for bleeding disorders.

This composite diagnostic image features three anteroposterior (AP) pelvic X-rays (labeled A, B, and C) illustrating a case of haemophilic arthropathy and its surgical management with bilateral total hip arthroplasty (THA). Panel A shows the preoperative state, characterized by severe bilateral degenerative changes in the hip joints. Visible features include significant joint space narrowing, subchondral sclerosis, and irregular femoral head morphology, typical of advanced haemophilic arthropathy. Panel B displays the immediate postoperative appearance after bilateral THA. Radiopaque prosthetic components are visible on both sides, consisting of acetabular cups, femoral heads, and femoral stems securely positioned within the medullary canals. Panel C is a one-year follow-up radiograph with a digitally enhanced overlay of the prosthetic hardware. The image demonstrates stable implant positioning without evidence of progressive radiolucent lines (> 2 mm), indicating successful osseointegration and maintenance of alignment. The series serves as an educational comparison between end-stage joint disease and successful surgical intervention in a patient with Haemophilia A.

This lateral x-ray radiograph of the left elbow demonstrates advanced features of neuropathic arthropathy (Charcot joint). The primary findings include significant destruction and resorption of the proximal radius and ulna, leading to marked joint disorganization and architectural deformity. There is prominent soft tissue swelling suggestive of extensive joint effusion or distension. Within this distended joint capsule, multiple radiopaque loose bodies or osseous debris are visible, scattered away from the primary joint surfaces. Subchondral sclerosis and increased bone density are present in the periarticular regions. These findings represent the mixed hypertrophic and atrophic patterns typical of neuropathic joints, frequently secondary to underlying conditions like diabetic neuropathy or syringomyelia. The clinical relevance lies in distinguishing these catastrophic degenerative changes from osteomyelitis or acute trauma in patients with diminished protective sensation.