The study examined the effect of prophylactic treatment on joint health in 41 patients with hemophilia A, hemophilia B, and von Willebrand disease type 3 using magnetic resonance imaging and IPSG-MRI scores. Of the patients, 28 (68%) had severe hemophilia, 10 (24%) moderate, and two (5%) had von Willebrand disease. Hemophilic arthropathy (joint damage) was observed in only 7 of 39 patients with hemophilia (18%), all of whom had a severe form. Only one of 19 patients receiving early prophylaxis developed arthropathy despite development of an inhibitor. The majority of joints (74%) showed no changes, 20% of joints had minor changes, and only 6% of joints had hemophilic arthropathy. The study demonstrates that reduced joint damage was associated with early diagnosis, consistent prophylaxis and adherence to treatment.