Multidisciplinary management of a significant quadriceps haematoma in an adolescent with mild haemophilia

Abstract

Muscle haematomas in patients with mild haemophilia may present differently to patients with severe haemophilia on prophylactic treatments. Bleeding in mild haemophilia is often related to surgery, invasive procedures, trauma and sporting injuries; a delay in presentation and treatment is common due to the lack of awareness of the seriousness of the condition. We discuss the management of an early adolescent male with a known mild haemophilia A diagnosis who presented to the hospital following blunt trauma to his thigh. Ultrasound demonstrated a large quadriceps intramuscular haematoma, which could increase the risk for compartment syndrome if not treated promptly or adequately. In this case, delayed treatment resulted in an inpatient admission and lengthy rehabilitation. This case report documents the multidisciplinary management, considering the medical, surgical, nursing, physiotherapy and medical imaging aspects of this presentation that effectively guided rehabilitation and return to sport complication-free.