title: Opinions on radiosynovectomy for chronic haemophilic synovitis: point/counterpoint.
abstract: Joint bleeding is the hallmark of severe haemophilia and the major cause of disability in patients with this coagulopathy. Repeated bleeding into the same joint can lead to chronic synovitis and progressive arthropathy. Radiosynovectomy is one option for the treatment of chronic haemophilic synovitis, but concerns about the risks of exposure to ionizing radiation have divided clinicians as to the safety and appropriate use of the procedure. This article presents two differing viewpoints, one from a pair of orthopaedic surgeons who collectively have performed more than 300 radiosynovectomies in patients with haemophilia. They maintain that radiosynovectomy is a simple, effective, safe and low-cost technique children and adults with chronic haemophilic synovitis. The other perspective is from an experienced haemophilia treater who directs a major US haemophilia treatment centre. She believes that unresolved questions about the safety of radiation exposure in children argue against the use of radiosynovectomy in paediatric patients with haemophilia.
authors: Los Angeles Orthopaedic Hospital, UCLA/Orthopaedic Hospital, Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90007, USA. msilva@mednet.ucla.edu
authors: M
authors: M
authors: Silva
authors: J V
authors: JV
authors: Luck
authors: C
authors: C
authors: Leissinger
mesh_terms: D001182:Arthroscopy; D025861:Blood Coagulation Disorders, Inherited / Q000150:complications*; D002908:Chronic Disease; D006801:Humans; D007596:Joints / Q000601:surgery; D010761:Phosphorus Radioisotopes / Q000627:therapeutic use; D016634:Radiosurgery; D012307:Risk Factors; D013585:Synovitis / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
chemical_list: D010761:Phosphorus Radioisotopes; D015021:Yttrium Radioisotopes