The Hemophilic Pseudotumor

Abstract

The pseudotumor is the most spectacular and serious of all the musculoskeletal lesions seen in hemophilia. It was first described, in the German literature, by Starker in 1918. Since then over one hundred cases have been reported. In a review of his experience at Oxford, Gunning (1966) estimated its incidence to be about 1% of all severe hemophiliacs. Most of these cases occurred before the advent of adequate factor replacement, and Gilbert stated in 1975 that “with improved treatment its incidence appears to be on the wane.” However, despite the availability of early factor replacement the elimination of this entity has not been achieved, a fair number of new lesions being seen each year. The natural history and clinical and radiologic manifestations have been well documented, but etiologic factors such as the original site of hemorrhage and the factors that lead to encapsulation rather than resorption remain obscure.