Development of radiographic changes in apparently normal joints at baseline with complete 5-year bleeding and follow-up radiographs (n = 70). The data were stratified according to the presence of MRI findings and report joint bleeding during 5-year follow-up (+, present; -, absent). Complete case analyses for patients with normal radiographs at baseline assessment and available data on 5-year bleeding and follow-up radiographs. Joints with baseline MRI findings (excluding joint effusion) had the highest chance of progression of arthropathy: 3 (75%) of 4 joints exhibited radiographic changes after 5 years. Joints without MRI findings exhibited radiographic changes in 1 (2%) of 66 joints only. Two joints with MRI findings at baseline developed clinical synovitis (**) after bleeding and exhibited radiographic changes as well. One other joint developed clinical synovitis (*), although it was normal on baseline MRI, did not experience bleeds, and was normal on follow-up radiographs.