Hemarthrosis (Joint Bleeding)

What is hemarthrosis?

Hemarthrosis is the medical term for bleeding that happens inside one of your joints. You might see it referred to as articular bleeding.

Joints are places in your body where bones meet. The joints that help you move are called synovial joints. They’re lined with a synovial membrane — a thin barrier that covers the space where your bones come together.

Your synovial membranes protect the joints they surround. They work with your cartilage, tendons and ligaments to reduce friction between the bones in your joints — especially when you’re moving them.

Hemarthrosis happens when something causes bleeding that leaks into your synovial membrane or the cavity inside one of your joints. It will cause swelling, and might make it hard to use your joint.

Hemarthrosis can develop in any synovial joint in your body, but it usually affects:

• Knees.
• Elbows.
• Hips.
• Shoulders.

Hemarthrosis can be caused by injuries, health conditions, as a side effect of medication and after joint surgeries. A healthcare provider will treat the cause of the bleeding and any symptoms you’re experiencing. Most people recover in a few weeks, depending on what caused the hemarthrosis.

You might have acute hemarthrosis — bleeding into a joint that’s temporary and caused by an injury or short-term illness. If you have a bleeding disorder that causes hemarthrosis to come back (recur) a healthcare provider may diagnose you with chronic hemarthrosis.

Visit a healthcare provider if you’re experiencing swelling around one of your joints — especially if it hurts or makes it hard to move.

Who does hemarthrosis affect?

Hemarthrosis can affect anyone. If you experience a trauma that affects one of your synovial joints, you might develop hemarthrosis.

People with certain health conditions are more likely to experience hemarthrosis, including:

• Hemophilia.
• Vitamin K deficiency.
• Some forms of arthritis — especially arthritis of the knee.
• Certain types of cancer.
• Liver disease.

How common is hemarthrosis?

It’s hard to estimate how common hemarthrosis is because it’s caused by many issues and conditions.

Studies have found that around half of all people with hemophilia will experience hemarthrosis at some point.

Half of all cases of hemarthrosis in knees are caused by ACL tears and other damage to knee ligaments.

What are the symptoms of hemarthrosis?

The most common symptoms of hemarthrosis include:

• Swelling and inflammation around one of your joints.
• Pain.
• Trouble moving.
• Bruising or discoloration.
• A feeling of warmth around a joint.

What causes hemarthrosis?

The most common causes of hemarthrosis include:

• Bleeding disorders.
• Trauma like falls, car accidents or sports injuries.
• Side effects from blood thinners (anticoagulant medications).
• Autoimmune diseases.
• Infections.

You might also experience hemarthrosis after you have surgery on one of your joints, including:

• Arthroplasty (joint replacement).
• Arthroscopy.
• Partial knee replacement.
• Knee osteotomy.

How is hemarthrosis diagnosed?

A healthcare provider will diagnose hemarthrosis with a physical exam and imaging tests. They’ll look at your affected joint and ask you about symptoms you’re experiencing.

They might check your range of motion (how far you can move a joint) and compare it to another healthy joint. For example, they’ll compare how far you can move your affected knee to your healthy knee. They might take a blood sample to check for an infection.

You might need one of a few imaging tests, including:

• X-rays.
• MRI (magnetic resonance imaging).
• CT (computed tomography) scan.
• Ultrasound.

Your provider may perform a joint aspiration (arthrocentesis). They’ll remove some of the excess fluid from around your joint and send it to a lab for testing.

Diagnosing hemarthrosis is usually part of a differential diagnosis — a list of conditions that share the same symptoms to help make a final diagnosis. Lots of issues and conditions cause swelling, so your provider will rule out other causes of your symptoms before diagnosing you with hemarthrosis.

How is hemarthrosis treated?

Your provider will treat the cause of the bleeding as well as the symptoms you’re experiencing. Usually, stopping the bleeding inside your joint will prevent your hemarthrosis symptoms from getting any worse. Which treatments you’ll need depends on what’s causing the bleeding. Your provider or surgeon will tell you what to expect. You may need a blood transfusion.

How can I manage hemarthrosis symptoms?

Usually, you can treat symptoms of hemarthrosis at home while you’re waiting for your joint to heal. You can use the RICE method. RICE stands for Rest, Ice, Compression and Elevation.

• Rest: Avoid putting any weight on your affected joint.
• Ice: Don’t apply ice directly to your joint. Instead, apply cold packs wrapped in a towel for no more than 20 minutes at a time, several times a day.
• Compression: You can wrap an elastic bandage around your joint. Make sure the bandage isn’t wrapped too tightly. Make sure the bandage doesn’t hurt.
• Elevation: Rest with your affected joint higher than the level of your heart.

Talk to your provider before taking any over-the-counter pain relievers (analgesics). Many common medications (including NSAIDs like aspirin, ibuprofen and naproxen) can thin your blood and make the hemarthrosis worse.

How can I prevent hemarthrosis?

You can’t prevent hemarthrosis because you can’t prevent the health conditions that cause it — and there’s no way to know when you’ll experience a trauma.

How long does it take to recover from hemarthrosis?

How long it takes to recover from hemarthrosis depends on what caused the bleeding into your joint. Some people recover in a few days if the bleeding stops quickly. Other cases of hemarthrosis take a few weeks to heal.

If the hemarthrosis was caused by a trauma like a bone fracture, you might take longer to recover. Talk to your provider or surgeon about what to expect. Ask them when you can start using your joint, and when it’s safe to resume physical activities.

When should I see my healthcare provider?

Visit a healthcare provider as soon as you notice any new swelling in or around one of your joints, especially if you have a bleeding disorder.

Go the emergency room if you’ve experienced a trauma or suddenly can’t move one of your joints.

What questions should I ask my doctor?

• Do I have hemarthrosis or another cause of swelling?
• What caused the bleeding?
• Which tests will I need?
• How will you treat the bleeding?
• Which medications are safe to take while I’m recovering?

What is the difference between hemarthrosis and join effusion?

Both hemarthrosis and joint effusion cause swelling around one of your joints.

Joint effusion happens when extra fluids flood the tissues around your joint. It’s a general term for any swelling in the area around of your joints. It can be caused by everything from injuries, overuse or infections. The fluid buildup might contain some blood, but it’s not only caused by bleeding.

Hemarthrosis occurs when something causes your body to bleed into your joint and the space around it. The swelling is caused by bleeding into your joint that leads to a buildup of blood in and around it.

Visit a provider if you notice new swelling around one of your joints.

A note from Cleveland Clinic

Hemarthrosis happens when bleeding inside your body makes blood pool around one of your joints. It’s important to get the bleeding stopped and its cause treated. Visit a healthcare provider as soon as you notice any swelling or bruising around one of your joints — especially if you’re in pain or it’s hard to move.

Even though you can treat some hemarthrosis symptoms at home, talk to a provider before taking any over-the-counter medications to treat pain or swelling. Many of the most common pain relievers can thin your blood and make the bleeding that caused hemarthrosis worse.