An 8-year-old with hemophilia has her leg splinted following a traumatic injury to the knee joint. The child complains of increased pain in the affected knee. Based on these findings, the cause of the pain is most likely due to:

Increased bleeding


•A patient with hemophilia is at risk for increased bleeding. Injury to a joint can cause severe bleeding into the synovial membrane (hemarthrosis), resulting in pain, swelling, and limited movement.

• Hemophilia is a hereditary bleeding disorder that reduces clotting factors in the blood. Platelets will aggregate, but the clot will not form. This causes the patient to bleed for a much longer time, but not more intensely.

•Treatment includes replacement of clotting factors via blood product transfusions. Desmopressin and antifibrinolytic therapy are also sometimes used.

•Muscle hypertrophy, decreased circulation to the affected extremity, and friction between adjacent articular joints is less likely the cause of pain in a patient with hemophillia.

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