Rheumatological management of patients with hemophilia. Part II: Muscle hematomas and pseudotumors.

Although less common than hemarthroses, muscle hematomas nearly always threaten limb function and can threaten life. Their treatment is not as well standardized as that of hemarthrosis but also rests on clotting factor replacement, prevention of contractures, and rehabilitation. Pseudotumors raise even greater treatment challenges and usually require surgery in adults. Presence of an inhibitor is no longer a contraindication to surgery. In HIV-infected patients, surgery is possible only if the CD4+ count is sufficiently high.