Synovectomy of the rheumatoid knee using intra-articular injection of dysprosium-165-ferric hydroxide macroaggregates.
One hundred and eleven patients who had seropositive rheumatoid arthritis and persistent synovitis of the knee were treated with intra-articular injection of 270 millicuries of dysprosium-165 bound to ferric hydroxide macroaggregates. A two-year follow-up was available for fifty-nine of the treated knees. Thirty-nine had a good result; nine, a fair result; and eleven, a poor result. Of the twenty-five knees that had Stage-I radiographic changes, nineteen had a good result. Of the thirty-four knees that had Stage-II radiographic changes, twenty showed a good result. Systemic spread of the radioactivity from the injected joint was minimum. The mean whole-body dose was calculated to be 0.3 rad and that to the liver twenty-four hours after injection, 3.2 rads. The results indicated that dysprosium-165-ferric hydroxide macroaggregate is an effective agent for performing radiation synovectomy, particularly in knees that have Stage-I radiographic changes. Because of the minimum rate of systemic spread of the dysprosium-165, it offers a definite advantage over agents that previously have been used.
Sledge
C B
CB
Brigham and Women's Hospital, Boston, Massachusetts 02115.
Zuckerman
J D
JD
Shortkroff
S
S
Zalutsky
M R
MR
Venkatesan
P
P
Snyder
M A
MA
Barrett
W P
WP
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000532:radiotherapy*; D004419:Dysprosium / Q000627:therapeutic use*; D005260:Female; D005290:Ferric Compounds / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D011868:Radioisotopes / Q000627:therapeutic use*; D011879:Radiotherapy Dosage; D013583:Synovial Membrane / Q000528:radiation effects*
D005290:Ferric Compounds; D011868:Radioisotopes; D004419:Dysprosium; C021024:ferric hydroxide