Ultrasound workshop in Indonesia teaches practical techniques for joint care

Healthcare professionals from across Southeast Asia gathered in Jakarta, Indonesia, for a World Federation of Hemophilia (WFH) musculoskeletal ultrasound workshop aimed at improving the detection and management of joint bleeds and long-term joint health in people with hemophilia. The hands-on training brought together orthopedic surgeons, physical therapists, physicians, rheumatologists, and hematologists to learn practical techniques that can transform patient care in both high- and low-resource settings.

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The training included experts from around the globe, all coming together to share their knowledge. There were two major objectives for the training: learning how to use a hand-held ultrasound device to detect early signs of a bleed in a joint, and learning how to inject a chemical synovectomy agent into a joint. Fourteen healthcare professionals took part, from the National Pediatric Hospital, Phnom Penh, Cambodia; Rumah Sakit Nasional Dr. Cipto Mangunkusumo, Indonesia, Jakarta; Hasan Sadikin Central General Hospital, Bandung, Indonesia; Yangon Children’s Hospital, Naypyidaw, Myanmar; University of Santo Tomas Hospital, Manila, Philippines; Mindanao Hemophilia Center, Davao, Philippines; Southern Philippines Medical Center, Davao, Philippines; and Hanoi Medical University Hospital, Hanoi, Vietnam.

One of the experts was Cindy Bailey, Director of Physical and Occupational Therapy, L.A. Orthopaedic Hospital PT, Los Angeles, U.S.A. Bailey emphasized how in addition to the workshop’s main objectives, the training had the added benefit of standardizing approaches to care. “The other reason we do this is to familiarize the physicians, the nurses, and the physical therapist with a specific system: image interpretation. We know exactly what we were looking for, and we can speak of that image together even if we are across the world.”

I am impressed by how active the physicians and healthcare providers here are, how eager they are to take up new information, they are going back to their countries and hospitals, to spread the word, spread the techniques… that’s the best way to provide new information to the world.

— Annette von Drygalski, MD, Professor of Clinical Medicine, and Director of the Hemophilia and Thrombosis Treatment Center, University of California, San Diego, U.S.A.

Participants travelled from across the region to go to the workshop and improve their skills. Jan-Tyrone Cabrera, MD, Assistant Professor, University of Santo Tomas, Manila, Philippines, said, “I think this [training] will be very beneficial for me… to be able to properly and systematically assess these joints, and also have a proper aid management for the different stages of hemophilic arthropathy.”

Pham Thu Hang, MD, Rheumatology Consultant, Hanoi University Hospital, Hanoi, Vietnam, described her motivation for attending: “I’m so glad to be here today because I want to improve my practice skills for my hospital for the care of hemophilia patients,” she said.

Cindy Bailey evaluating the joint using the point-of-care ultrasound device.
Cindy Bailey evaluating the joint using the point-of-care ultrasound device.
Annette von Drygalski, MD, demonstrating the ultrasound-guided joint injections using the Joint Tissue Activity and Damage Exam (JADE) protocol.
Annette von Drygalski, MD, demonstrating the ultrasound-guided joint injections using the Joint Tissue Activity and Damage Exam (JADE) protocol.

Annette von Drygalski, MD, Professor of Clinical Medicine, and Director of the Hemophilia and Thrombosis Treatment Center, University of California, San Diego, U.S.A., who was there to train participants, underscored the impact of new handheld ultrasound technology in ultrasound techniques. “This [new technology] will change our practice in that there will be no more blind injections of medications,” she explained, adding that participants are eager to take new techniques back to their home countries. The workshop highlighted the commitment of the WFH to building sustainable clinical capacity and improving outcomes for people with hemophilia worldwide.

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