A 9-year-old boy with haemophilia A and recurrent knee bleeds has a knee radiograph showing widened intercondylar notch, squared inferior patella, bulbous remodelling of the femoral condyles, and uniform joint space narrowing with epiphyseal overgrowth. The most likely diagnosis is:

• A Juvenile idiopathic arthritis
• B Legg-Calve-Perthes disease
• C Tuberculous arthritis of the knee
• D Haemophilic arthropathy ✓

Explanation

Repeated intra-articular haemorrhage causes synovial hypertrophy and cartilage destruction, producing the classic triad of a widened intercondylar notch, squaring of the inferior patellar pole, and bulbous enlargement of the femoral condyles, together with epiphyseal overgrowth from hyperaemia. Juvenile idiopathic arthritis shares some features but does not produce the characteristic patellar squaring and condylar bulbous remodelling combination.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.