CO025 | HEPHAESTUS: A DIGITAL ATLAS FOR TRAINING AND STANDARDIZATION OF JOINT POINT-OF-CARE ULTRASOUND IN HEMOPHILIC ARTHROPATHY

R. Gualtierotti^1|2, N. D'Amico³, S. Mascetti³, M. Fassi¹, A. Giachi¹, C. Bettini³, F. Peyvandi^1|2 | ¹Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milano, Italy; ²Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy; ³Department of Computer Science, Università degli Studi di Milano, Milano, Italy

Background. Medical imaging plays a central role in hemophilia care, particularly for evaluating joint involvement and detecting bleeding-related damage. Point-of-care ultrasound (POCUS) represents a non-invasive, accessible tool for early diagnosis and longitudinal monitoring of hemophilic arthropathy. However, its widespread clinical implementation remains limited by the lack of structured training programs and standardized protocols for image acquisition and interpretation. Although several ultrasound scoring systems and guidelines have been proposed, dedicated digital resources are still needed to support systematic education and harmonization of practice.
Aims. The HEmoPHilic Arthropathy E-atlas for Standardization and Training in Joint UltraSound (HEPHAESTUS) project was developed to address these unmet needs by providing a comprehensive, evidence-based training platform for joint POCUS.
Methods. A web-based educational atlas was designed through collaboration between clinicians, radiologists, and computer science experts. The platform integrates current international recommendations for standardized ultrasound assessment of the three joints most commonly affected in hemophilia: elbows, knees, and ankles. High-quality ultrasound images and video recordings were collected from patients with different ages, disease severities, and stages of arthropathy. All materials were reviewed, annotated, and validated by experienced operators.
Results. The platform includes a curated collection of representative cases, ranging from early synovial hypertrophy to advanced osteochondral damage. Content is organized within a structured learning environment comprising theoretical tutorials, more than 60 case-based examples, and progressive selfassessment modules with expert feedback. Interactive tools enable users to compare their own interpretations with validated reference annotations, facilitating both guided instruction and independent learning. The system supports repeated practice, standardized reporting, and continuous skill development.
Conclusions. The HEPHAESTUS digital atlas represents an innovative educational resource aimed at improving training and standardization of joint POCUS in hemophilia care. A pilot evaluation involving hematologists, physiotherapists, and radiologists will assess usability, feasibility, and educational impact. By promoting consistent image acquisition and interpretation, this platform may reduce inter-operator variability, enhance diagnostic accuracy, and support earlier detection and monitoring of joint disease. Wider dissemination of this tool has the potential to foster international collaboration and strengthen the integration of POCUS into routine hemophilia management, ultimately contributing to improved longterm outcomes for people with hemophilia.