虽然老年患者罹患获得性血友病-A相对较少见，但其在临床上仍存在重大挑战，特别是当伴随深度肌肉骨骼并发症时更为突出。血肿可能被误认为肿瘤，进一步加重了诊断过程的复杂性。一个85岁的男性病人，既往病史有高血压、前列腺增生和右侧腹股沟疝，出现了左下肢急性疼痛、功能受限和髂腰肌和腋窝区的深层血肿。根据放射学发现，对髂腰肌中的骨肉瘤病灶的初步怀疑被组织病理学检查推翻，检查结果证实存在坏死性出血组织。患者接受了一个月的物理治疗方案，重点是针对下肢肌肉，特别是髋关节周围的肌肉。 病情的严重程度以及髂腰肌和股四头肌等重要肌肉的受累凸显了全面康复的重要性。一致的治疗干预，针对肌肉力量和关节功能，通过HJHS、HAL和FISH评分的明显改善得到了证实。多学科综合治疗方法，包括血液学、康复和支持措施，对确保病人的整体恢复起着至关重要的作用。 老年人获得性血友病-A需要综合护理方法，包括准确诊断和个体化治疗干预。本案例强调了专门物理治疗在处理这种出血性疾病的肌肉骨骼影响方面的转变潜力，突显了早期干预和全面护理的价值。 版权所有 © 2023作者及Elsevier Ltd.保留所有权利。

Acquired haemophilia-A, although uncommon in elderly patients, poses significant clinical challenges, especially when associated with profound musculoskeletal complications. The potential mimicry of hematomas as tumors further complicates the diagnostic process.An 85-year-old male, with a remote history of hypertension, benign prostatic hyperplasia, and right inguinal hernia, presented with acute pain in the left lower limb, functional limitation, and deep hematomas in the ileopsoas and axillary region. Initial suspicions of a sarcomatous lesion in the ileopsoas, based on radiological findings, were refuted following histopathological examinations, which confirmed the presence of necrotic hemorrhagic tissue. The patient underwent a one-month physical therapy regimen, targeting lower extremity muscles, especially around the hip joint.The severity of the presentation and the involvement of vital muscles like the ileopsoas and quadriceps underscored the importance of comprehensive rehabilitation. Consistent therapeutic interventions, targeting muscle strength and joint function, demonstrated marked improvement as evidenced by the HJHS, HAL, and FISH scores. The multidisciplinary approach, entailing hematological, rehabilitative, and supportive measures, was paramount in ensuring holistic patient recovery.Acquired haemophilia-A in the elderly necessitates an integrative care approach, encompassing accurate diagnosis and tailored therapeutic interventions. This case emphasizes the transformative potential of dedicated physiotherapy in managing the musculoskeletal implications of this bleeding disorder, underscoring the value of early intervention and comprehensive care.Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.