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An acutely painful elbow as a first presentation of von Willebrand's disease.
  1. H D Poncia,
  2. J Ryan
  1. Department of Accident and Emergency Medicine, Royal Sussex County Hospital, Brighton.

    Abstract

    A 26 year old woman presented to the accident and emergency department with a painful right elbow. There had been no history of trauma. Clinical examination suggested an effusion, which was confirmed on radiological examination. Her elbow was aspirated and revealed a haemarthrosis. Subsequent investigations revealed a diagnosis of von Willebrand's disease (vWD). A spontaneously occurring effusion of the elbow may be due to a haemarthrosis. Aspiration of blood in the absence of trauma may lead to a diagnosis of an occult coagulopathy in addition to relieving pain. The diagnosis and treatment of vWD is discussed.

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