A 1 year old boy presents with a swelling of his right elbow joint for 4 hours. His mother says that this occurred after he tripped and hit his elbow on the floor.

He was diagnosed with severe Hemophilia A at 7 months of age, after developing an epidural hematoma following a fall from his cradle.

Since then, he has experienced a mild nose bleed, and a large bruise over his left knee, both following falls.

At the time of diagnosis, factor VIII activity was measured to be 0.9%. He is currently on recombinant factor VIII prophylaxis. His medical and surgical histories are otherwise unremarkable.

His family history is significant for a maternal uncle with Hemophilia. All immunizations are up to date. He lives with his mother and stepfather.