Deep muscle bleeding often requires follow-up treatment and observation by the center staff. Sling, splints or crutches may be necessary for support for several days. Joint Bleeding As the person with hemophilia grows, bleeding into his joints will occur more frequently. Early signs of bleeding are the reluctance to use the affected limb followed by a slight swelling in the affected joint. Attempts to move the joint forcibly cause pain.
Flexion increases the space in the joint, making more room for further bleeding to occur.
If untreated, the bleeding continues until the area feels hot and rock hard. Early treatment with clotting factor usually prevents the pain from becoming severe, and since only a small amount of blood will have leaked into the joint space, recovery will be quick, although the joint will sustain some permanent damage. In addition to pain considerations, inadequately treated bleeding irritates the joint surface which eventually leads to arthritis. A large volume of blood, which results from delayed treatment, takes longer to re-absorb into the body. The longer the period of irritation, the greater the chance of arthritic damage.