Learning objectives
1.
Bring the radiologist to the knowledge of this technique and show our experience.
2.
Assess the mechanisms of action,
main indications and contraindications.
3.
Show the techniques we use in our service and possible complications.
Background
Radiosynovectomy (Synonyms: radiosynoviorthesis)is a local treatment method,
indicated in different rheumatological,
acute and chronic processes,
when despite conventional treatment,
for more than 6 months and / or intraarticular infiltrations of corticosteroids,
there is still involvement of some joints,
and when an increase in the dose of these drugs can have serious side effects in the patient (11)
Radiosynoviorthesis consists of the intra-articular injection of a radionuclide,
beta-emitting (10) This technique was used for the first time in 1952 by K.
Fellinger and Schmid for the...
Findings and procedure details
Previous study
It is advisable to have an RX or MRI of the last 6 months in patients candidates for an radiosynoviorthesis
Joint ultrasonography may be useful to evaluate the presence of synovial effusion and / or thickening / synovitis,
or to exclude rupture of a Baker's cyst or massive hemarthrosis.
It may be useful to have a osseus gammagraphy (2 or 3 phase) to evaluate the severity of soft tissue and joint inflammation,
particularly if multiple joints are affected (8) and for post-treatment assessment...
Conclusion
The RSO can,
in many cases,
relieve pain and restore quality of life even in those patients who do not respond sufficiently to other treatments There are few studies that meet the criteria of evidence-based medicine in terms of methodology,
sample size or comparison with other local therapies or placebo.
This may be due in part to the fact that the use of the RSO is not widely spread in all countries due to legal and administrative limitations in the use of radioisotopes (10) The...
Personal information
Dr.
Santiago Carbullanca Resident in training.
Department of Radiology,
Hospital del Mar.
Passeig Marítim,
25-29,
08003 Barcelona,
Spain. Email:
[email protected]
References
•1-W.
U.
Kampen,
M.
Voth ,
J.
Pinkert and A.
Krause.
Therapeutic status of radiosynoviorthesis of the knee with yttrium [90Y] colloid in rheumatoid arthritis and related indications..
Rheumatology 2007;46:16–24
•2-Kresnik E,
Mikosch P,
Gallowitsch HJ et al.
Clinical outcome of radiosynoviorthesis: a meta-analysis including 2190 treated joints.
Nucl Med Commun 2002;23:683–8
•3-Farahati J,
Schulz G,
Wendler J et al.
Multivariate analysis of factors influencing the effect of radiosynovectomy.
Nuklearmedizin 2002;41:114–9.
•4-Jahangier ZN,
Jacobs JW,
van Isselt JW,
Bijlsma JW.
Persistent synovitis treated with radiation...