hemarthrosis and hemophilia

[MudPhud20XX]

So another UW question says:

"Hx of prolonged bleeding after dental extractions and surgeries and of spontaneous hemorrhages into the joints (hemarthrosis) is typical for hemophilia"

I would agree that such symptoms indicate secondary hemostasis dz. So is it b/c of the fact that hemarthroses is particularly common in hemophilia? how about in vWF dz or in vit K def? Why?
Many thanks in advance.

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[SBR249]

I think deep bleeding like hemarthroses points to a coagulation pathway defect whereas superficial bleeding (like mucous membranes or petechiae) is more likely for a primary hemostasis defect like platelet dysfunction or Von Willebrand Disease.

 

[thehundredthone]

With vit K deficiency or warfarin overanticoagulation you can sometimes see skin manifestations but for the most part, like SBR249 said, coagulation disorder is associated with deeper bleeding and platelet disorders with superficial bleeding.

Why? I don't remember reading any specific mechanism, but perhaps because superficial capillary breakage is a common occurrence and a primary haemostatic disorder will expose this phenomenon. Similarly superficial wounds are primarily countered by the primary haemostatic mechanism and so a defect in the mechanism will mean that these wounds last longer.

 

[MudPhud20XX]

thank you guys. I was just a bit thrown off by UW solution's statement "Hx of prolonged bleeding after dental extractions and surgeries and of spontaneous hemorrhages into the joints (hemarthrosis) is typical for hemophilia"

I was wondering perhaps hemarthrosis was a more specific symptom toward hemohpilia (than other secondary hemostasis dz).... Anyway, thanks for the feedback!

 

[thehundredthone]

Yes it is.