Clinical efficacy of radiation synovectomy in digital joint osteoarthritis.
OBJECTIVE
Radiation synovectomy was developed for local treatment of rheumatoid arthritis. In this study, the long-term efficacy of radiation synovectomy was retrospectively evaluated in patients with osteoarthritis (activated arthrosis) of the digital joints using an algofunctional score.


METHODS
Fifty-three digital joints in 29 patients (mean age 64.8 years) were treated by intra-articular injection of 169Er citrate. All joints were painful despite pharmacotherapy and showed an elevated blood pool pattern in a pretherapeutic three-phase bone scan, indicative for local synovitis. The patients were asked to classify their complaints with respect to different daily manual activities on a ten-step pain scale from 1 (total disability) to 10 (lack of any impairment) prior to and after treatment, with a mean follow-up of 41 months. Local signs of osteoarthritis such as joint swelling or pain were additionally evaluated and were scored from progression of complaints to excellent improvement based on patient self-evaluation.


RESULTS
All patients reported a pronounced improvement in their manual activities. The mean total score of 4.73+/-0.58 for all activities prior to treatment increased significantly to 6.79+/-0.47 after radiation synovectomy (p<0.05). The best results were obtained in the thumb base joints, whereas distal interphalangeal joints were frequently resistant to therapy.


CONCLUSIONS
Radiation synovectomy is highly effective in digital joint osteoarthritis with concomitant local synovitis.
Kampen
Willm Uwe
WU
Clinic of Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 9, 24105, Kiel, Germany. ukampen@nuc-med.uni-kiel.de
Hellweg
Leif
L
Massoudi-Nickel
Schirin
S
Czech
Norbert
N
Brenner
Winfried
W
Henze
Eberhard
E
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000209:etiology / Q000517:prevention & control*; D004871:Erbium / Q000008:administration & dosage*; D005260:Female; D005384:Finger Joint / Q000528:radiation effects*; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications / Q000175:diagnosis* / Q000532:radiotherapy*; D010147:Pain Measurement / Q000379:methods; D011868:Radioisotopes / Q000008:administration & dosage*; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D020127:Recovery of Function / Q000528:radiation effects; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D011868:Radioisotopes; D019275:Radiopharmaceuticals; D004871:Erbium