title: Radioisotope synoviorthesis in paediatric and adolescent patients with haemophilia.
abstract: OBJECTIVE
  To assess the outcome and adverse-effects of the radioisotope synoviorthesis in paediatric and adolescent patients with haemophilia.
  
  
  METHODS
  Prospective study of historical cohort was conducted. A total of 20 consecutive haemophiliacs with a mean age of 13.1 years (range 4-17) were included with a mean follow-up of 64.9 months (range 18-109). The diagnosis of synovitis was established on the basis of clinical follow-up including radiological images (radiography and/or MRI). For evaluation, the classification proposed by Fernandez-Palazzi was used.
  
  
  METHODS
  Patients aged less than 18 years old with haemophilia and more than one haemarthrosis in less than 3 months remaining a chronic synovitis despite prophylactic therapy intensification.
  
  
  METHODS
  Any contraindication for radionuclide synoviorthesis. Twenty-seven radioisotope synoviorthesis with (90)Y-citrate-colloid and/or (186)Re-sulphide-colloid were done. The effectiveness of the procedure was assessed through pre and posttreatment clinical comparison at 6 months after radioisotope synoviorthesis.
  
  
  RESULTS
  Nineteen of the 27 synoviorthesis (70.3%) had a good or excellent response and 8 joints (29.7%) had partial response. It was necessary to repeat the procedure in 3 joints in 3 different patients, obtaining in all cases a good or excellent response. We appreciated inflammatory reaction after procedure in 4 cases (14.8%), which improved with analgesics and nonsteroidal anti-inflamatory drugs. None of the patients presented malignant or premalignant lesions during the follow-up.
  
  
  CONCLUSIONS
  The radionuclide synoviorthesis is a very effective procedure in paediatric and adolescent patients with hemophilia, being a minimally invasive procedure, easy to perform, safe and with minimal side effects.
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: andres.martinez.esteve@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Esteve
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: R M
authors.initials: RM
authors.lastname: Álvarez-Pérez
authors.affiliation: Servicio de Hematología, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: R
authors.initials: R
authors.lastname: Núñez-Vázquez
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: J L
authors.initials: JL
authors.lastname: Tirado-Hospital
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: R
authors.initials: R
authors.lastname: García-Jiménez
authors.affiliation: Servicio de Reumatología, Hospital Universitario Virgen Macarena, Sevilla, España.
authors.forename: J
authors.initials: J
authors.lastname: Povedano-Gómez
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: I
authors.initials: I
authors.lastname: Borrego-Dorado
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002951:Citrates / Q000009:adverse effects / Q000627:therapeutic use; D003102:Colloids; D006395:Hemarthrosis / Q000209:etiology / Q000517:prevention & control / Q000532:radiotherapy*; D006467:Hemophilia A / Q000150:complications*; D002836:Hemophilia B / Q000150:complications; D065386:Historically Controlled Study; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D009942:Organometallic Compounds / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use; D012211:Rhenium / Q000009:adverse effects / Q000627:therapeutic use; D013440:Sulfides / Q000009:adverse effects / Q000627:therapeutic use; D013585:Synovitis / Q000209:etiology / Q000517:prevention & control / Q000532:radiotherapy*; D016896:Treatment Outcome
chemical_list: D002951:Citrates; D003102:Colloids; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; D013440:Sulfides; C400124:rhenium sulfide; D012211:Rhenium; C045937:yttrium citrate
keywords: (186)Re; (90)Y; Adolescent; Adolescente; Haemophilia; Hemofilia; Paediatric; Pediátrico; Radioactive synoviorthesis; Sinoviortesis radioisotópica