[The indication for radiosynoviorthesis. From the perspective of the nuclear medicine expert, rheumatic orthopedist and internist].
Radiosynovectomy or radiosynoviorthesis (RSO), the intra-articular injection of beta-emitting radionuclides (e.g. colloidal preparations of 90-Yttrium, 186-Rhenium or 169-Erbium), is an approved, reliable and easily performed therapy for the treatment of chronic synovitis without harmful side effects. The best clinical results have been obtained in patients with predominantly inflammatory joint disease such as rheumatoid arthritis or reactive arthritis. But RSO is also established to treat pain and persistent effusions after total knee replacement. It also represents an adjuvant therapy in patients with pigmented villonodular synovitis to protect against recurrence following synovectomy. In patients with hemophilia and arthropathy a reduction in joint bleeding is seen and the use of coagulation factor is reduced. The indication for RSO should be made in close cooperation between the referring physician, the rheumatologist and the nuclear medicine expert in the context of a multimodal therapy concept. In this way, success rates of over 80%, with only few side effects, can be achieved, particularly in rheumatoid arthritis, reactive arthritis and hemophilic arthropathy.
Klinik für Nuklearmedizin, Klinikum Bremen-Mitte, St.-Jürgen-Str. 1, 28177, Bremen. rainer.linke@klinikum-bremen-mitte.de
R
R
Linke
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Gelse
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Schuch
D001172:Arthritis, Rheumatoid / Q000532:radiotherapy*; D005858:Germany; D006801:Humans; D007388:Internal Medicine / Q000639:trends*; D009683:Nuclear Medicine / Q000639:trends*; D009985:Orthopedics / Q000639:trends*; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D012219:Rheumatology / Q000639:trends*; D013583:Synovial Membrane / Q000528:radiation effects*; D016896:Treatment Outcome
D019275:Radiopharmaceuticals
Z Rheumatol. 2006 May;65(3):239-44
16450152
Am J Clin Oncol. 2006 Dec;29(6):548-50
17148989
HSS J. 2009 Feb;5(1):19-23
19096892
Z Rheumatol. 1999 Apr;58(2):71-8
10408067
Arthritis Rheum. 1994 Apr;37(4):481-94
8147925
Haemophilia. 2007 Nov;13 Suppl 3:32-7
17822519
Arch Orthop Trauma Surg. 1979 Jan 29;93(2):95-102
420562
Best Pract Res Clin Rheumatol. 2007 Oct;21(5):871-83
17870033
Rheumatology (Oxford). 2002 Oct;41(10):1113-8
12364629
Z Rheumatol. 2008 Oct;67(6):485-90
18777027
J Rheumatol. 1999 Jun;26(6):1242-9
10381037
Nucl Med Commun. 2002 Sep;23(9):829-31
12195084
Osteoarthritis Cartilage. 2008 Feb;16(2):137-62
18279766
J Rheumatol. 1997 Feb;24(2):365-71
9034998
Ann Rheum Dis. 2000 Aug;59(8):583-6
10913051
Ann Rheum Dis. 2005 May;64(5):669-81
15471891
Ann Intern Med. 2007 Mar 20;146(6):406-15
17371885
J Nucl Med. 2005 Jan;46 Suppl 1:48S-54S
15653651
Eur J Nucl Med Mol Imaging. 2003 Mar;30(3):BP12-6
12723558
Arthritis Rheum. 2005 Nov;52(11):3391-402
16255016
Orthopade. 1998 Mar;27(3):188-96
9585928
Ann Rheum Dis. 2003 Mar;62(3):251-3
12594113
J Am Acad Orthop Surg. 2004 Jan-Feb;12(1):55-64
14753798
Rheumatology (Oxford). 2007 Oct;46(10):1531-7
17596287
J Rheumatol. 2004 Feb;31(2):321-8
14760804
Nuklearmedizin. 1999;38(6A):254-5
10510824
Nucl Med Commun. 2001 Feb;22(2):239-46
11258412
Ann Rheum Dis. 2003 Nov;62(11):1054-60
14583567
Orthopade. 2007 Aug;36(8):723-8
17634922
Ann Rheum Dis. 2008 Jun;67(6):815-22
17878209
Lancet. 2004 Jul 17-23;364(9430):263-9
15262104
Haemophilia. 2008 May;14(3):513-7
18248407
Haemophilia. 2010 Nov;16(6):932-6
20518818
Presse Med. 1968 May 4;76(22):1045-50
5648676
Nucl Med Commun. 2002 Jul;23(7):683-8
12089491
Arthritis Rheum. 2007 Nov;56(11):3662-9
17968947
Radiologe. 2009 Jan;49(1):59-67
18597065
Ann Rheum Dis. 2003 Jan;62(1):43-9
12480668
Eur J Nucl Med Mol Imaging. 2005 May;32(5):575-80
15599524
Nuklearmedizin. 2006;45(6):262-8
17149495