Point-of-care musculoskeletal ultrasound for hemophilic arthropathy: a scoping review of scanning protocols by the Imaging Expert Working Group of the International Prophylaxis Study Group.

Background: People with hemophilia (PwH) or von Willebrand disease (VWD) are at risk of joint bleeding, which can lead to hemophilic arthropathy. Point-of-care musculoskeletal ultrasound (POC-MSKUS) is increasingly used to detect joint bleeds, but a comprehensive compilation of available independent scanning protocols and their respective measurement properties is missing. Objectives: This study aimed to identify all existing POC-MSKUS scanning protocols and their reported measurement properties in PwH or people with VWD. Methods: A scoping review was conducted using Embase, MEDLINE, and CINAHL (March 2025). Studies were included if they were peer-reviewed; published in English; used an experimental, observational, or review design; and examined POC-MSKUS for joint disease in children or adults with hemophilia A, hemophilia B, or VWD. Extracted data included scanning protocol characteristics and measurement properties such as reliability (interrater and intrarater), construct validity (convergent and known groups), criterion validity (concurrent and predictive), and responsiveness. Results: Of 926 identified studies, 134 met the inclusion criteria (3 systematic reviews, 7 experimental studies, 75 observational studies, 39 narrative reviews, and 10 studies using other acceptable designs). Thirteen POC-MSKUS scanning protocols were identified. Among the 70 studies assessing measurement properties, reliability was reported in 12 studies, construct validity in 43 studies, criterion validity in 20 studies, and responsiveness in 5 studies. Predictive validity (2 studies) and responsiveness were the least reported properties. Conclusion: Several POC-MSKUS scanning protocols exist, with predictive validity and responsiveness being the least established measurement properties. Future research should focus on prospective and experimental studies to establish these properties in POC-MSKUS protocols for PwH and people with VWD.