Most bleeding in hemophilia occurs internally, into the joints or muscles. The joints that are usually affected are the ankle, knee, hip, elbow, and shoulder. Repeated bleeding without prompt treatment can damage the cartilage and the bone in the joint, leading to chronic arthritis and disability. Muscle bleeds most commonly occur in the upper arm, forearm, upper leg, calf, and iliopsoas muscle (the front of the groin area).
Some bleeds can be life-threatening and require immediate treatment. These include bleeds in the head, throat, gut, or iliopsoas. Bruises are very common in children with hemophilia. A bruise is not usually cause for alarm unless it is on the person’s head or neck, the person has a hard time moving, the bruise hurts, the lump in the bruise gets larger or does not go away, or if there is swelling, numbness, or a tingling feeling along with the bruising. If any of these symptoms are experienced, contact your physician or local hemophilia treatment center.