20 April 2015

Answer: What's your diagnosis? – Case 7

In our latest case, we met a boy who would not stop bleeding after a doctor attempted to place a drip.


In our latest case we met Mrs B and her son child A who presented to the family GP with a swollen knee after the boy fell of his bike. In hospital the doctor found that the sites where he attempted to place a drip would not stop bleeding. Read the full case study here.

Hemophilia is a relatively rare inherited genetic condition. With hemophilia the body can not, due to insufficient blood clotting factors, clot blood effectively, and therefore significant bleeding (even from small cuts) is a problem. This was an important clue in Child A's history when he would not stop bleeding.  

The fact that Child A had a warm, swollen knee after the fall is of great concern as this could indicate infection (like in the case of septic arthritis), a possible fracture or, as in his case, a bleed in the joint. "Deep bleeds" (bleeding in joints or organs) are of particular concern as this may result in damage to the joint or the organs where the bleeds occur and may have detrimental effects on the joints, or even be life-threatening if the bleed is not diagnosed in time in the case of organs.

Signs and symptoms

·         Excessive bleeding with injuries, or continuous bleeding with even minor cuts

·         Pain, swelling, limited movement of joints 

·         Easy bruising (often large and extensive)

·         Noticing blood when passing urine or stool (occasional)

·         Unexplained nosebleeds

Hemophilia is an inheritable disease, so where the condition runs in families, genetic testing may be possible. There is no cure for hemophilia, but people who suffer from the condition can live a full and active life. Best would be to avoid contact sports as this increases the risk of sustaining a deep bleed or open injury. 

NOTE: Health24's on-site GP Dr Owen Wiese reveals new cases on Thursdays. The answer is posted with the story on Mondays, or you can get it on the Daily Tip – sign up here.

Previously on What's Your Diagnosis?

What's your diagnosis? – Case 1: vomiting and weight loss

What's your diagnosis? – Case 2: eye pain

What's your diagnosis -  Case 3: strange behaviour and a bullet in the back

What's your diagnosis - Case 4: seeing odd things

What's your diagnosis - Case 5: mysterious lungs

What's your diagnosis - Case 6: runner with seizures

Image: Joint bleeds in hemophilia from Shutterstock

Dr. Owen J. Wiese is Health24's resident doctor. After graduating from Stellenbosch University with additional qualifications in biochemistry and physiology he developed a keen interest in providing medical information through the media.


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