Reliability assessment of the OMERACT whole-body magnetic resonance imaging scoring system for juvenile idiopathic arthritis.

Inter-reader reliability of a new scoring system for evaluating joint inflammation and enthesitis in whole body MRI (WBMRI) in juvenile idiopathic arthritis was tested. The scoring system grades 732 item-region combinations of bone marrow and soft tissue changes for commonly involved joints and entheseal sites. Five radiologists rated 17 WBMRI scans through an online rating platform. Item-wise reliability was calculated for 117 items with non-zero scores in >10 % of readings. Interquartile ranges of the five-reader Kappa reliability coefficients were 0.58-0.73 (range: 0.36-0.88) for the joints, 0.65-0.81 (range: 0.39-0.95) for the entheses, and 0.62-0.75 (range: 0.60-0.76) for chronic nonbacterial osteomyelitis-like lesions.

Elevated DAS28-ESR in patients with rheumatoid arthritis who have comorbid fibromyalgia is associated more with tender joint counts than with patient global assessment or swollen joint counts: implications for assessment of inflammatory activity.

OBJECTIVES: More than 20% of rheumatoid arthritis (RA) patients have comorbid fibromyalgia (FM+), which may elevate DAS28-ESR (disease activity score 28-erythrocyte sedimentation rate) and other indices, resulting in challenges to assess inflammatory disease activity. Although several reports indicate that elevated patient global assessment (PATGL) may elevate DAS28 in the absence of inflammatory activity, less information is available concerning the other three components, tender joint count (TJC), swollen joint count (SJC), and erythrocyte sedimentation rate (ESR), to possibly elevate DAS28 in FM+ vs. FM- RA patients. METHODS: A PubMed search identified 14 reports which presented comparisons of DAS28-ESR and its four components in RA FM+ vs. FM- groups. Median DAS28, component arithmetic differences, pooled effect sizes and 95% confidence intervals were analysed in the FM+ vs. FM- groups. RESULTS: In FM+ vs. FM- groups, median DAS28 was 5.3 vs. 4.2, SJC 4.0 vs. 3.0, TJC 13.2 vs. 5.3, PATGL 61.6 vs. 39.9, ESR 26.3 vs. 26.5. DAS28-ESR was classified as "high" (>5.1) in 11/14 FM+ groups and "moderate" (3.2-5.1) in all 14 FM- groups. Effect sizes in FM+ vs. FM- groups for DAS28-ESR, SJC, TJC, PATGL, and ESR were large (≥0.8) in 10/14, 1/13, 12/13, 7/13, and 1/13 comparisons, respectively, and pooled effect sizes 0.84 (0.3, 1.4), 0.33 (-0.4, 1.0), 1.27 (0.01, 2.5), 0.91 (-0.6, 2.4), and 0.07 (-0.6, 0.7), respectively. CONCLUSIONS: DAS28-ESR is elevated significantly in FM+ vs. FM- RA patients; pooled effect sizes were highest for TJC, followed by PATGL, SJC and ESR. The findings appear relevant to response and remission criteria, treat-to-target, and general management of RA.

A post hoc comparative real-world analysis of HEAD-US score for joint health assessment of patients with severe haemophilia A and B in Spain.

AIM: Joint damage due to haemarthrosis can be effectively monitored with point-of care ultrasound using the Haemophilia Early Arthropathy Detection with US (HEAD-US) scoring system. A post hoc comparative analysis of the joint status of patients with severe haemophilia A (HA) or B (HB) was performed. METHODS: The databases of two observational, cross-sectional studies that recruited patients with HA or HB from 12 Spanish centres were analysed to compare the status of the elbows, knees and ankles in patients with severe disease according to treatment modality. The HEAD-US score was calculated in both studies by the same trained operators. RESULTS: Overall, 95 HA and 41 HB severe patients were included, with a mean age of 35.2 ± 11.8 and 32.7 ± 14.2 years, respectively. The percentage of patients who received prophylaxis, over on-demand (OD) treatment, was much higher in HA (91.6%) than in HB (65.8%) patients. With a similar number of target joints, the HEAD-US score was zero in 6.3% HA and 22.0% HB patients (p < .01), respectively. The HA population showed significantly worse HEAD-US scores. Whilst osteochondral damage occurred more frequently in patients OD or tertiary prophylaxis, our data suggest that articular damage is less prominent in primary/secondary prophylaxis, regardless of the type of haemophilia. These latter treatment modalities were also associated with a lower prevalence of synovial hypertrophy, particularly in HB patients. CONCLUSION: This post hoc analysis indicates that joint status seems to be significantly influenced by haemophilia type (HA or HB) and treatment modality in these severe Spanish populations with severe disease. Continuing HEAD-US monitoring for the early detection and management of intra-articular abnormalities, as well as more efficiently tailored therapies should be warranted.

Radiographic assessment of the pubic symphysis in elite male adolescent football players: Development and reliability of the Maturing Adolescent Pubic Symphysis (MAPS) classification.

INTRODUCTION: The pubic symphysis is susceptible to growth related injuries long after the adolescent growth spurt. Our study describes the radiographic maturation of the pubic symphysis on pelvic radiographs in adolescent football players and introduces the Maturing Adolescent Pubic Symphysis classification (MAPS classification). METHODS: Anteroposterior pelvic radiographs of 105 healthy adolescent male football players between 12 and 24 years old were used to develop the classification system. The radiological scoring of the symphyseal joint was developed over five rounds. The final MAPS classification items were scored in random order by two experienced readers, blinded to the age of the participant and to each other's scoring. The inter- and intra-rater reliability were examined using weighted kappa (κ). RESULTS: We developed a classification system with descriptive definitions and an accompanying pictorial atlas. The symphyseal joint was divided into three regions: the superior corners, and the upper and lower regions of the joint line. Inter-rater reliability was substantial to almost perfect: superior region: κ = 0.70 (95% CI 0.60---0.79), upper region of the joint line: κ = 0.89 (95% CI 0.86---0.92), lower region of the joint line: κ = 0.65 (95% CI 0.55---0.75). The intra-observer reliability showed similar results. CONCLUSION: The Maturing Adolescent Pubic Symphysis classification (MAPS classification) is a reliable descriptive classification of the radiographic maturation of the pubic symphysis joint in athletic males. The stages can provide a basis for understanding in clinical practice and will allow future research in this field.

Proprioceptive Acuity Assessment in Multiple Directions Across Multiple Joints in the Upper Limb.

Proprioception is essential for precise movement as it helps the body transmit important data about its surroundings to the central nervous system for maintaining body posture and position. This study aimed to investigate the effect of direction and joint angle on upper limb proprioception. Thirty individuals (all males) completed a position reproduction activity in 13 directions and three joint angles. It was discovered that upper limb proprioception is dependent on joint angle, direction, and range of motion. The position reproduction error was found to be dependent on the direction, which had a significantly lower accuracy in the direction with a larger range of motion. In addition, upper limb repositioning errors increased at greater limb elevation angles. Our findings also showed that the joint angle did not significantly affect the absolute error of elbow flexion. With an increase in the elbow flexion, the increase of the gravitational moment of the upper arm and hand coupled with the increase of the muscle arm of the biceps brachii possibly causes slight changes in muscle length perceived by spindles or muscular force perceived by Golgi tendon organs.

Intra and inter observer agreement in the mobility assessment of the upper thoracic costovertebral joints.

BACKGROUND: Determining the mobility of the costovertebral joints might be important in patients with neck-upper thoracic pain. Little research has been performed on observer agreement when assessing the mobility of these joints. PURPOSE: The purpose of this study was to determine intra- and inter-observer agreements when assessing costovertebral joint mobility of the upper three ribs in those with and without neck pain and to compare the difference between the Kappa and AC statistic. METHODS: Forty-four participants, with and without current neck/upper-thoracic pain, were assessed by two raters. Raters applied a posterior to anterior pressure to the anatomical neck of the first three ribs bilaterally. Mobility was graded: normal, increased, or decreased. An AC1, for nominal data, AC2 for ordinal data, and the Kappa statistics were used to analyze the results. The AC statistics determines chance agreement different than Kappa. RESULTS: AC1 showed "moderate to very good" (0.74-1.0) intra-rater reliability, while inter-rater reliability showed "fair to good" agreement (0.51-0.79). Using the AC2 Intra-rater reliability was "very good" and "almost perfect" (AC2: 0.93-1.0), while using the AC2 was "good to very good" and "good to almost perfect" (0.76-0.94). Kappa values for intra-rater reliability ranged from "fair to moderate" (0.38-0.54), while inter-rater reliability ranged from "poor to fair" (-0.10-0.26). CONCLUSION: Posterior/anterior pressure is a reliable method to assess the mobility of the upper costovertebral joints. Assessing costovertebral mobility is important when establishing a movement diagnosis in patients with neck/upper thoracic pain.

Mechanical Energy Expenditure at Lumbar Spine and Lower Extremity Joints During the Single-Leg Squat Is Affected by the Nonstance Foot Position.

ABSTRACT: Hirsch, SM, Chapman, CJ, Frost, DM, and Beach, TAC. Mechanical energy expenditure at lumbar spine and lower extremity joints during the single-leg squat is affected by the nonstance foot position. J Strength Cond Res 36(9): 2417-2426, 2022-Previous research has shown that discrete kinematic and kinetic quantities during bodyweight single-leg squat (SLS) movements are affected by elevated foot positioning and sex of the performer, but generalizations are limited by the high-dimensional data structure reported. Using a 3D inverse dynamical linked-segment model, we quantified mechanical energy expenditure (MEE) at each joint in the kinetic chain, the total MEE (sum of MEE across aforesaid joints), and the relative contribution of each joint to total MEE during SLSs performed with elevated foot positioned beside stance leg (SLS-Side), and in-front of (SLS-Front) and behind (SLS-Back) the body. Total MEE differed between SLS variations ( p = 0.002), with the least amount observed in the SLS-Back (effect size [ES] = 0.066-0.069). Approximately 50% of total MEE was contributed by the knee joint in each SLS variation, whereas MEE at the ankle, hip, and lumbar spine (in absolute and relative terms) varied complexly as a function of the elevated foot position. Total MEE ( p = 0.0192, ES = 0.852) and the absolute MEE at the knee and spine was greater in men across the SLS variations performed ( p = 0.025-0.036, ES = 0.715-0.766), but only the lumbar spine contribution to total MEE was larger in men across all SLS variations ( p = 0.045, ES = 0.607). Otherwise, there were no other sex-specific responses observed. Biomechanically, SLS movements are generally "knee-dominant," but changing elevated foot position effectively redistributes MEE among other joints in the linkage. Consistent with the previous conclusions reached based on discrete kinematic and kinetic data, not all SLSs are equal.

The role of tender and swollen joints for the assessment of inflammation in PsA using ultrasound.

OBJECTIVE: To evaluate tender joints (TJ) and swollen joints (SJ) for the assessment of ultrasound (US) defined inflammation in PsA. METHODS: Eighty-three PsA patients underwent clinical and US examinations at two scheduled study visits 12 months apart. Tenderness and swelling were assessed at 68 and 66 joints, respectively, and US examinations were conducted at all 68 joints. At patient level, associations with clinical composites and US scores were performed using correlations and by analysing patients with predominantly tender (pTender) or swollen joints (pSwollen). At joint level, a Power Doppler (PD) value ≥ 1 was defined as active synovitis. A generalized linear mixed model was created to assess the predictive value of TJ and SJ for active synovitis after 12 months. RESULTS: SJC showed better correlations with GS/PD scores (r = 0.37/0.47) than with TJC (PD: r = 0.33), while TJC correlated better with patient reported outcomes (PROMs) like patient global assessment (TJC: r = 0.57; SJC r = 0.39). Patients with pTender showed poorer results for PROMs and disease activity scores than patients with pSwollen, but not for laboratory or US markers of inflammation. Swollen joints showed active synovitis in 35% of cases, while only 16% of tender joints were active according to US. Swelling at baseline better predicted active synovitis at the same joint after 12 months [odds ratio (OR) 6.33, P <0.001] as compared with tenderness (OR 3.58, P <0.001). CONCLUSIONS: SJ are more closely linked with US signs of inflammation as compared with TJ in PsA. Joint swelling is a better predictor for signs of US inflammation than tenderness after one year of follow-up.

Low cost exoskeleton manipulator using bidirectional triboelectric sensors enhanced multiple degree of freedom sensory system.

Rapid developments of robotics and virtual reality technology are raising the requirements of more advanced human-machine interfaces for achieving efficient parallel control. Exoskeleton as an assistive wearable device, usually requires a huge cost and complex data processing to track the multi-dimensional human motions. Alternatively, we propose a triboelectric bi-directional sensor as a universal and cost-effective solution to a customized exoskeleton for monitoring all of the movable joints of the human upper limbs with low power consumption. The corresponding movements, including two DOF rotations of the shoulder, twisting of the wrist, and the bending motions, are detected and utilized for controlling the virtual character and the robotic arm in real-time. Owing to the structural consistency between the exoskeleton and the human body, further kinetic analysis offers additional physical parameters without introducing other types of sensors. This exoskeleton sensory system shows a great potential of being an economic and advanced human-machine interface for supporting the manipulation in both real and virtual worlds, including robotic automation, healthcare, and training applications.

Nuances of Radiographic Assessment of Distal Radius Fractures to Avoid Missed Fragments.

Distal radius fractures, like many articular and periarticular fractures, can make it difficult to determine the true number, location, and orientation of fracture fragments. This article should help the reader work through imaging interpretation starting from the initial, often displaced radiographs to postreduction imaging and determination if further 3-dimensional imaging is necessary.

In vitro assessment of the motion of equine proximal sesamoid bones relative to the third metacarpal bone under physiologic midstance loads.

OBJECTIVE: To assess the motion of the proximal sesamoid bones (PSBs) relative to the third metacarpal bone (MC3) of equine forelimbs during physiologic midstance loads. SAMPLE: 8 musculoskeletally normal forelimbs (7 right and 1 left) from 8 adult equine cadavers. PROCEDURES: Each forelimb was harvested at the mid-radius level and mounted in a material testing system so the hoof could be moved in a dorsal direction while the radius and MC3 remained vertical. The PSBs were instrumented with 2 linear variable differential transformers to record movement between the 2 bones. The limb was sequentially loaded at a displacement rate of 5 mm/s from 500 N to each of 4 loads (1.8 [standing], 3.6 [walking], 4.5 [trotting], and 10.5 [galloping] kN), held at the designated load for 30 seconds while lateromedial radiographs were obtained, and then unloaded back to 500 N. The position of the PSBs relative to the transverse ridge of the MC3 condyle and angle of the metacarpophalangeal (fetlock) joint were measured on each radiograph. RESULTS: The distal edge of the PSBs moved distal to the transverse ridge of the MC3 condyle at 10.5 kN (gallop) but not at lower loads. The palmar surfaces of the PSBs rotated away from each other during fetlock joint extension, and the amount of rotation increased with load. CONCLUSIONS AND CLINICAL RELEVANCE: At loads consistent with a high-speed gallop, PSB translations may create an articular incongruity and abnormal bone stress distribution that contribute to focal subchondral bone lesions and PSB fracture in racehorses.

Inertial measurement units for the detection of the effects of simulated leg length inequalities.

BACKGROUND: Leg length inequalities (LLI) are a common condition that can be associated with detrimental effects like low back pain and osteoarthritis. Inertial measurement units (IMUs) offer the chance to analyze daily activities outside a laboratory. Analyzing the kinematic effects of (simulated) LLI on the musculoskeletal apparatus using IMUs will show their potentiality to improve the comprehension of LLI. METHODS: Twenty healthy participants with simulated LLI of 0-4 cm were analyzed while walking with an inertial sensor system (MyoMotion). Statistical evaluation of the peak anatomical angles of the spine and legs were performed using repeated measurement (RM) ANOVA or their non-parametric test versions (Friedman test). RESULTS: Lumbar lateral flexion and pelvic obliquity increased during the stance phase of the elongated leg and decreased during its swing phase. The longer limb was functionally shortened by higher hip and knee flexion, higher hip adduction, dorsiflexion, and lower ankle adduction. Finally, the shorter leg was lengthened by higher hip and knee extension, hip abduction, ankle plantarflexion, and decreased hip adduction. CONCLUSION: We found differing compensation strategies between the different joints, movement planes, gait phases, and amounts of inequality. Overall the shorter leg is lengthened and the longer leg is shortened during walking, to retain the upright posture of the trunk. IMUs were helpful and precise in the detection of anatomical joint angles and for the analysis of the effects of LLI.

Moderate to Substantial Inter-Rater Reliability in the Assessment of Cranial Bone Mobility Restrictions.

Background: The World Health Organization benchmarks for osteopathic training consider cranial osteopathy as an important manual skill. Studies of cranial manual therapy have exhibited poor reliability. The aim of this study was to investigate the inter-rater reliability of the manual mobility tests of the spheno-occipital synchondrosis (SOS), and the temporal, parietal, and frontal bones, as assessed in osteopathic manual therapy. Methods: Twenty-one adults were assessed on a single day by three experienced osteopaths using a standard assessment protocol. Before data collection, the osteopaths participated in a consensus training, which included establishing the criteria for identifying a cranial bone mobility restriction; the application of the seven-step palpation method; a pretesting practice; a fine-tuning palpation training; and a calibration period before the assessment of the subjects. Three subjects were assessed simultaneously with the evaluators rotating to assess each subject. The evaluators were blinded to the subject by a curtain, and each other's assessments. Each bone was rated as restricted or not restricted. The authors applied the Landis and Koch classification to describe the magnitude of inter-rater reliability. Results: Moderate reliability was established for a lateral strain of the SOS (Fleiss' generalized kappa 0.48), substantial reliability was established for the other SOS strain patterns (Fleiss' generalized kappa 0.62-0.75), and almost perfect reliability for temporal, parietal, and frontal bone (Fleiss' generalized kappa 0.81-0.96). Conclusion: The results demonstrate consistency when three experienced osteopaths evaluate cranial bone mobility restrictions. The results highlight the importance of consensus training and rigorous methodology in manual therapy reliability studies.

Patient Global Assessment of Disease Activity and Radiographic Progression in Early Arthritis: Three-Year Results From the ESPOIR Cohort.

OBJECTIVE: To determine whether patient global assessment of disease activity (PtGA) over the first year of disease course, as part of a Boolean-based definition of remission and considered individually, had a significant relationship with structural progression over 3 years in patients with early arthritis. METHODS: We conducted a prospective, observational study using ESPOIR (Étude et Suivi des Polyarthrites Indifférenciées Récentes) cohort data. Remission states were defined as 1) 4-variable remission, which included a tender joint count in 28 joints, a swollen joint count in 28 joints (SJC28), a C-reactive protein (CRP; mg/dl) level, and PtGA (scored 0-10, all scores of ≤1); 2) PtGA near remission, which included the same parameters as 4-variable remission with only PtGA >1 (of a maximum possible score of 10); 3) 3-variable remission (sum of the proportion of patients in 4-variable remission and the proportion of patients in PtGA near remission); or 4) nonremission. The strictest status satisfied both at 6 and 12 months was considered. Radiographic progression was determined as a change of ≥5 points in the total Sharp/van der Heijde score (ΔSHS) from baseline to 3 years. The predictive capacities for radiographic damage of different remission definitions were assessed by odds ratio (OR). The association between each individual component of remission with ΔSHS was tested through multivariate linear regression analyses. RESULTS: Among 520 patients, 7% achieved 4-variable remission and 12% achieved PtGA near remission. Radiographic progression was observed in 29% of patients who achieved 4-variable remission (OR versus nonremission; OR 0.32 [95% confidence interval (95% CI) 0.15, 0.68]) and in 45% of patients with PtGA near remission (OR 0.65 [95% CI 0.38, 1.11]); the comparison was not statistically different (OR 0.49 [95% CI 0.20, 1.18]). In 3-variable remission, radiographic progression was observed in 39%. Of the individual components, only the SJC28 and CRP level were associated with radiographic progression. CONCLUSION: All definitions of remission led to low structural degradation in early arthritis, and 4-variable remission led to less radiographic progression than PtGA near remission, but without a statistically significant difference. Both 4-variable remission and 3-variable remission appear to be useful targets when aiming for structural nonprogression.

Reliability of the high-speed camera-based system (hsc-kinovea) for lower-limb explosive strength endurance assessment in athletes / Confiabilidade do sistema de câmera de alta velocidade (cav-kinovea) para avaliação da resistência de força explosiva de membros inferiores em atletas

ABSTRACT The present study verified the reliability of the high-speed camera-based system (HSC-Kinovea) in the lower-limb explosive strength endurance assessment in athletes. Eleven male volleyball players (21.8 ± 2.9 years; 186.3 ± 6.2 cm and 82.3 ± 11.0 kg) participated in the intermittent vertical jumping test in two days. The test was filmed and later analyzed using Kinovea 0.8.15 software to obtain the mean and peak power variables. Regarding reliability, the intra-class correlation coefficient, the typical error of measurements, and Bland-Altman plots were used. The method presented satisfactory values for inter and intra-class correlations (˃ 0.88). The typical values error of measurement presented in the inter-rater analysis was 0.95 W.kg-1 and 0.59 W.kg-1 for the peak and the mean power, respectively. In the intra-assessment analyses, the typical measurement error values were 7.02 W.kg-1 and 5.66 W.kg-1 (test-retest) and 1.59 W.kg-1 and 0.24 W.kg-1 (duplicates videos) for peak and average power, respectively. The HSC-Kinovea system is reliable for assessing the variables of the explosive strength endurance in athletes.

RESUMO O presente estudo verificou a confiabilidade do sistema baseado em câmeras de alta velocidade (CAV-Kinovea) na avaliação da resistência de força explosiva de membros inferiores em atletas. Onze atletas masculinos de voleibol (21.8 ± 2.9 anos de idade; 186.3 ± 6.2 cm and 82.3 ± 11.0 kg) participaram do teste de saltos verticais de contexto intermitente em dois dias. O teste foi filmado e posteriormente analisado no software Kinovea 0.8.15 para obter as variáveis ​​de potência pico e média. Para determinar a confiabilidade, utilizou-se o coeficiente de correlação intraclasse, o erro típico de medidas e os gráficos de Bland-Altman. O método apresentou valores satisfatórios para as correlações inter e intra-classe (˃0,88). Os valores do erro típico de medida apresentados na análise interavaliadores foram 0,95 W.kg-1 e 0,59 W.kg-1 para potência pico e média, respectivamente. Nas análises intra-avaliação, os valores do erro típico de medida foram 7,02 W.kg-1 e 5,66 W.kg-1 (teste-reteste) e 1,59 W.kg-1 e 0,24 W.kg-1 (duplicados de vídeos ) para potência pico e média, respectivamente. O sistema CAV-Kinovea é confiável para avaliar as variáveis da resistência de força explosiva em atletas.

3D gait analysis, haemophilia joint health score, leg muscle laterality and biomarkers of joint damage: A cross-sectional comparative assessment of haemophilic arthropathy.

INTRODUCTION: 3D gait analysis has been proposed as a reproducible and valid method to assess abnormal gait patterns and to monitor disease progression in patients with haemophilia (PWH). AIM: This study aimed at comparing Gait Deviation Index (GDI) between adult PWH and healthy controls, and at assessing the agreement between outcome measures of haemophilic arthropathy. METHODS: Male PWH aged 18-49 years (prespecified subgroups: 18-25 vs 26-49 years) on prophylactic replacement therapy, and male healthy age-matched controls passed through a cross-sectional assessment panel. Besides the 3D gait analysis derived GDI, secondary outcomes included kinematic, kinetic and spatio-temporal gait parameters, the Haemophilia Joint Health Score (HJHS), electric impedance derived leg muscle laterality and inflammatory biomarkers. RESULTS: Patients with haemophilia (n = 18) walked slower, in shorter steps and accordingly with less functional range of motion in the hips and ankles, as compared to healthy controls (n = 24). Overall, PWH did not differ significantly in GDI and specific gait parameters. PWH had a higher mean HJHS (18.8 vs 2.6, P = .000) and leg muscle laterality (4.3% vs 1.5%, P = .004). A subgroup analysis revealed progressed gait pathology in PWH aged 26-49 years (not statistically significant). Leg muscle laterality was strongly correlated with HJHS (r = .76, P = .000), whereas GDI just moderately (r = -.39, P = .110). PWH had higher levels of the inflammatory markers CRP and IL-6. CONCLUSION: Progressed gait pathology was found in PWH, mainly those aged 26-49 years. Leg muscle laterality correlated strongly with HJHS and was identified as a promising tool for detecting progression and physiological consequences of haemophilic joint arthropathy.

HJHS 2.1 and HEAD-US assessment in the hemophilic joints: How do their findings compare?

: In hemophilic patients methods are needed to better diagnose joint damage early, so that treatments can be adjusted to slow the progression of hemophilic arthropathy. The aim of this study is to investigate the relationship between the Hemophilia Joint Health Score version 2.1 (HJHS 2.1) and hemophilia early arthropathy detection with ultrasound (HEAD-US) scales, as well as each of their individual items, to better understand the value each provides on the joint condition of patients with hemophilia. The study included data from patients with hemophilia older than 16 years of age, who attended a routine check-up. HJHS 2.1 and HEAD-US assessments were performed on the elbows, knees and ankles. We studied the correlations and agreements between the two scales and analyzed the relationship between the various items of the HJHS 2.1 (inflammation, duration, atrophy, crepitation, flexion deficit, extension deficit, pain, strength, gait) and HEAD-US (synovitis, cartilage and bone). The study included 203 joints from 66 patients with hemophilia (mean age, 34 years). We found a good correlation between the two scales (r = 0.717). However, HJHS 2.1 revealed only 54% of the cases with synovitis and 75% of the cases with osteochondral damage. HEAD-US detected several relevant physical and functional aspects in less than 53% of the cases. HJHS 2.1 and HEAD-US provide complementary data on joint disease in adults with hemophilia; both assessments should therefore, be made available. HEAD-US presented the added value of detecting early joint changes (synovitis and osteochondral damage), while HJHS 2.1 showed the added value of detecting relevant physical and functional changes.