[Radiosynovectomy for the treatment of rheumatoid arthritis of the elbow joint].
The aim of this retrospective study was to evaluate the efficacy of radiosynovectomy (RSO) in patients with rheumatoid elbow arthritis.


METHODS
40 joints of 31 patients were evaluated. At the time of therapy, patients had been suffering from elbow arthritis for 17.5 months (2-72 months). 95% of the joints (n = 38) had severe daily pain or continuous pain, 97.5% (n = 39) had moderate to severe limitation of the mobility and 10% (n = 4) had severe swelling. RSO was performed by intraarticulär injection of 74 MBq colloidal rhenium-186 and 15 mg triamcinolonehexacetonide. Before and six to 26 months after therapy (median follow-up 14.7 months) severity of the patients pain, mobility and swelling (transferred to a scoring system) were determined with a standardised questionnaire. A clinical re-evaluation, along with an orthrosonographical follow-up was performed in 28 joints.


RESULTS
A "good to very good" overall long-term response was achieved in 80% (n = 32) of the treated joints and a temporary response in 10% (n = 4). Only 10% (n = 4) had a non-satisfactory response due to advanced articular destruction. The range of motion for flexion-extension increased from 103.8 +/- 20.0 degrees to 144.0 +/- 12.8 degrees (p < 0.001). The respective scores for articular pain, impaired mobility and swelling decreased significantly (pain from 3.15 to 0.82, impaired mobility from 3.15 to 0.82, swelling from 2.40 to 0.65; p < 0.001). No deterioration or complication occurred. The effects lasted throughout the entire follow-up time for 36 joints (90%).


CONCLUSIONS
For patients with rheumatoid involvement of the elbow joint, radiosynovectomy results in a significant decrease of articular pain and improvement of objective parameter, i.e. joint mobility. Thus, radiosynovectomy represents a feasible and effective therapeutic option for elbow arthritis.
Rozeboom
S
S
Klinik für Nuklearmedizin und PET-Center Stuttgart, Katharinenhospital, Klinikum Stuttgart, Deutschland.
Dörr
U
U
Bihl
H
H
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000601:surgery*; D004551:Elbow Joint; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain; D016634:Radiosurgery; D012189:Retrospective Studies; D000074402:Synovectomy; D016896:Treatment Outcome