Radiosynoviorthesis (Radiation Synovectomy)

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

“…Fundamentally, RSO is indicated for the local treatment of almost all kinds of chronic synovitis independent of the underlying disease (Mödder 1995a, b;Kampen et al 2001Kampen et al , 2002Kampen et al , 2007Fischer and Mödder 2002;Hoefnagel et al 1999;Farahati et al 2006;Brenner 2006, Das et al 2004Mödder and Mödder-Reese 2011).…”

Treatment response evaluation using Yttrium-90 in patients with rheumatoid arthritis of knee joint

“…If a particle diameter is not large enough to avoid leakage out of the joint cavity by venous or lymphatic drainage, it would result in an increased irradiation of the whole body and particularly of the locoregional lymph nodes, the liver, and the spleen. [ 6 7 ] For radiosynovectomy of the knee joint, the recommended activity per joint is usually 185–222 MBq (5–6 mCi). The clinical outcome of radiosynovectomy in meta-analysis including 2190 treated joints was successful in 66.7% ±15.4% of rheumatoid arthritis.…”

“…The clinical outcome of radiosynovectomy in meta-analysis including 2190 treated joints was successful in 66.7% ±15.4% of rheumatoid arthritis. [ 7 ] There was a difference according to the steinbrocker stages (Steinbrocker I: 72.8% ±12.3%; Steinbrocker II: 64% ±17.3%; Steinbrocker III and IV: 52.4% ±23.6%). [ 8 ]…”

Radiosynovectomy in Hemophilic Synovitis

“…After intra-articular administration, the radioactive colloids are phagocytized by the macrophages of the inflamed synovium. The release of beta radiation leads to coagulation necrosis, fibrosis and sclerosis of the synovial tissue also including vessels and pain receptors ( 3 , 10 ). If the technique is properly performed, the radioisotope affects synovial cells only due to its low range of radiation and no adverse effect is expected in the cartilage tissue, surrounding bone structures or other parts of the body.…”

“…Due to the radiation safety concerns for patients and the medical staff, the injection room, monitoring of radioactive substances, the disposal of radioactive wastes and all the other related safety precautions should be managed by the Nuclear Medicine physician and the physicist. The measurement of injected dose, the use of finger dosimeters, acrylic syringe protectors or nitrile or vinyl gloves should be considered in terms of safety precautions ( 10 ).…”