Hemarthrosis: Genes & Biomarkers Summary Gene / Biomarker Bad Score Free Actions Non-free Actions GENES BIOMARKERS F8 F9 VWF F13A1 PROS1 FVIII/FIX Activity aPTT VWF Panel hs-CRP / IL-6 Ferritin/Iron Panel MMP-3 FVIII <1% → severe HA Family hx, joint diary Genetic test, FVIII Rx FIX <1% → severe HB Joint protect, physio FIX replacement, gene Rx VWF:Ag <30 IU/dL No NSAIDs, bleed diary VWF/FVIII concentrate Clot instability risk Avoid trauma FXIII concentrate, FFP Protein S deficiency Activity monitoring Anticoagulation therapy <1% activity Activity log, joint assess Prophylaxis / on-demand Prolonged >35 s Re-test, symptom review Factor assays, coag panel VWF:Ag <30 IU/dL Dietary iron, hydration VWF concentrate, DDAVP hs-CRP >10 mg/L Ice, rest, elevate NSAIDs, synovectomy Ferritin >200 µg/L Monitor joint drainage Iron chelation, synovect. >100 ng/mL Joint monitor, physio Synovectomy, biologics