2. You attend A&E to review the young boy.
– He was previously known at a different centre but the family have only recently moved to the area. The family have a planned appointment in a few weeks at the local haemophilia centre.
– He has a diagnosis of haemophilia A and has never needed any treatment before. Mum has a letter from his previous centre showing that he has a factor VIII level of <1%.
– Mum says he started walking at 17 months of age. He has had a few ‘bumps and bruises’ on his legs but nothing that caused a problem. He had a normal delivery with no complications.
– He has no siblings and he has a maternal uncle with haemophilia A.
– A few hours ago he was climbing on the sofa and fell off the sofa arm onto his knee. Mum put a cold pack on his leg but is concerned that he won’t walk on the leg and the swelling seems to be increasing.
– On examination he is reluctant to weight bear, the knee is flexed and it is painful on passive movement. The knee is swollen and red.
What should happen now?
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