title: The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy.
abstract: OBJECTIVE
  We aimed to assess the role of Magnetic Resonance Imaging (MRI) and X-Ray in the evaluation of response to radiosynovectomy (RS) in patients with hemophilic arthropathy.
  
  
  METHODS
  Eleven patients who suffered from hemophilic arthropathy with a mean age of 11.7 (range between 7-15) were included in this study. 148-185 MBq Yttrium 90 silicate (Y-90) was administered intraarticularly to ten knee joints and one patient was treated with intraarticular 74 MBq Rhenium 186 (Re-186) injection into his ankle. Before radiosynovectomy, plain anteroposterior and lateral X-rays of the target joints were obtained by standard technique. The follow-up MRI and X-ray studies of the patients were done 6 months after RS. Pettersson hemophilic arthropathy scales were utilized to stage the condition of the joints on plain X-ray and classification of the investigated joints on MRI were done according to Denver score. The clinical assessment of the efficacy of the RS was made with the comparison of the average bleedings before and after the intervention.
  
  
  RESULTS
  During the 6-month follow-up period after RS, an improvement in number of hemarthrosis 75% or greater compared with the prior six months occurred in six joints (54.5%). The Pettersson scores worsened in 1/11 (9%), remained unchanged in 9/11 (81.8%), and improved in 1/11 (9%) joints. At the 6-month follow-up, the MRI score worsened in one (9%) and was unchanged in 10/11 joints (90.9%).
  
  
  CONCLUSIONS
  MRI is a more sensitive tool than plain radiography for evaluating and follow-up of joint disease in persons with hemophilia, but both methods don't show correlation with the therapeutic response Conflict of interest:None declared.
authors.affiliation: Okmeydanı Training Hospital, Nuclear Medicine, İstanbul, Turkey.
authors.forename: Tamer
authors.initials: T
authors.lastname: Ozülker
authors.forename: Filiz
authors.initials: F
authors.lastname: Ozülker
authors.forename: Esin
authors.initials: E
authors.lastname: Derin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Altun
authors.forename: Gönül
authors.initials: G
authors.lastname: Aydoğan
authors.forename: Emine
authors.initials: E
authors.lastname: Türkkan
authors.forename: Müjdat
authors.initials: M
authors.lastname: Adaş
authors.forename: Murat
authors.initials: M
authors.lastname: Tonbul
authors.forename: Tevfik
authors.initials: T
authors.lastname: Ozpaçacı
authors.forename: Funda
authors.initials: F
authors.lastname: Sezgin
authors.forename: Hülya
authors.initials: H
authors.lastname: Değirmenci
keywords: Radiosynovectomy; hemophilic arthropathy; magnetic resonance imaging; therapy response