Radionuclide Therapy of Inflammatory Joint Diseases (Radiation Synovectomy, Radiosynoviorthesis)

Mödder, Gynter

doi:10.1007/174_2013_823

Cited by 5 publications

(13 citation statements)

References 54 publications

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“…The joint is punctured using ultrasonographic or fluoroscopic guidance and a solution of colloidal radioactive agent is intra-articularly injected. The diameter of the colloid particle is between 2 and 5 µm, which is small enough to be phagocytised, but big enough not to enter bloodstream via capillary fenestrations [ 5 , 6 ]. Immediately after the injection, most of the radiocolloid is phagocytised by type 2 synoviocytes (synovial macrophages) and captured in the external cell layers of the synovial membrane.…”

Section: Mechanism Of Actionmentioning

confidence: 99%

“…Strict adherence to rules of aseptic technique is mandatory, with sterilization of the patient's skin and use of sterile drapes and gloves. However, the actual risk of infection is minimal, since β - radiation is a potent antiseptic [ 6 ].…”

Section: Performing Radiosynovectomymentioning

confidence: 99%

“…This makes ‘blind’ joint puncture unacceptable, and RS should be performed using imaging guidance ( Fig. 3 ) [ 6 ].…”

Section: Performing Radiosynovectomymentioning

confidence: 99%

“…In the case of large joints (knee, hip, shoulder), a small amount of glucocorticoid is injected during RS. This is done in order to reduce inflammation induced by radiation in the course of tissue damage (radiosynovitis), which can clinically manifest as a transient pain flare [ 6 ]. Some authors argue against use of glucocorticoids, advising intra-articular administration of a 1–2% solution of lidocaine instead [ 22 ].…”

Section: Performing Radiosynovectomymentioning

confidence: 99%

“…After RS, it is recommended to immobilize the treated joint for at least 48 hours, to minimize the risk of radioactive leakage to para-articular tissues. In the case of lower limb joint treatment (hip, knee, ankle), the patient is advised not to walk and thus requires the assistance of third parties [ 6 ].…”

Section: Performing Radiosynovectomymentioning

confidence: 99%

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Radionuclide synovectomy – essentials for rheumatologists

Chojnowski¹,

Felis-Giemza²,

Kobylecka³

2016

Reumatologia

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Radionuclide synovectomy is a minimally invasive method of treating persistent joint inflammation. It involves intra-articular injection of radioactive colloids which induce necrosis and fibrosis of hypertrophic synovial membrane. The most common indication for radiosynovectomy is rheumatoid arthritis, although patients with seronegative spondyloarthropathies, unclassified arthritis, haemophilic arthropathy and other less common arthropathies can also benefit from this method. Radiosynovectomy is safe, well tolerated and efficacious. About 70–80% of patients respond well to the therapy. However, the therapeutic effects are considerably worse in patients with co-existent osteoarthritis and advanced joint degeneration. Despite its advantages, radionuclide synovectomy is not performed as often as it could be, so greater knowledge and understanding of this method are needed. The authors present the most important facts about radiosynovectomy that may help rheumatologists in their daily clinical practice.

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Section: Mechanism Of Actionmentioning

confidence: 99%

Section: Performing Radiosynovectomymentioning

confidence: 99%

“…This makes ‘blind’ joint puncture unacceptable, and RS should be performed using imaging guidance ( Fig. 3 ) [ 6 ].…”

Section: Performing Radiosynovectomymentioning

confidence: 99%

Section: Performing Radiosynovectomymentioning

confidence: 99%

Section: Performing Radiosynovectomymentioning

confidence: 99%

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Radionuclide synovectomy – essentials for rheumatologists

Chojnowski¹,

Felis-Giemza²,

Kobylecka³

2016

Reumatologia

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The EANM guideline for radiosynoviorthesis

Kampen¹,

Boddenberg-Pätzold

Fischer³

et al. 2021

Eur J Nucl Med Mol Imaging

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Purpose Radiosynoviorthesis (RSO) using the intraarticular application of beta-particle emitting radiocolloids has for decades been used for the local treatment of inflammatory joint diseases. The injected radiopharmaceuticals are phagocytized by the superficial macrophages of the synovial membrane, resulting in sclerosis and fibrosis of the formerly inflamed tissue, finally leading to reduced joint effusion and alleviation of joint pain. Methods The European Association of Nuclear Medicine (EANM) has written and approved these guidelines in tight collaboration with an international team of clinical experts, including rheumatologists. Besides clinical and procedural aspects, different national legislative issues, dosimetric considerations, possible complications, and side effects are addressed. Conclusion These guidelines will assist nuclear medicine physicians in performing radiosynoviorthesis. Since there are differences regarding the radiopharmaceuticals approved for RSO and the official indications between several European countries, this guideline can only give a framework that must be adopted individually.

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Adverse reactions to therapeutic radiopharmaceuticals

Silindir-Gunay,

Ozolmez

2024

Applied Radiation and Isotopes

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Radionuclide Therapy of Inflammatory Joint Diseases (Radiation Synovectomy, Radiosynoviorthesis)

Cited by 5 publications

References 54 publications

Radionuclide synovectomy – essentials for rheumatologists

Radionuclide synovectomy – essentials for rheumatologists

The EANM guideline for radiosynoviorthesis

Adverse reactions to therapeutic radiopharmaceuticals

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