In February 2010, Mr. M, a 27-year-old male, had a similar injury mechanism as discussed in Case  1, again playing football. He presented to the emergency department with pain and swelling and was at this stage neurovascularly intact. However, over the next 24 hrs his haematoma expanded and he underwent a fasciotomy due to neurovascular compromise. He was referred to haematology with isolated prolonged APTT of 40.2 seconds (normal range 21-32 seconds) and was diagnosed with mild haemophilia A.
One week later, Mr. M returned with increased pain and swelling. Mr. M received recombinant Factor VIII preoperatively and underwent a femoral arteriogram plus embolisation for two pseudoaneurysms (Figure 5). His haematoma was evacuated and a drain was inserted. Mr. M underwent extensive family screening revealing another brother and cousin with haemophilia. He currently remains active playing multiple sports. His current management strategy after minor trauma includes self-medicating with DDAVP. Mr M regularly attends the haemophilia outpatient department were his concerns are addressed by the multidisciplinary team (Table 1).