title: Efficacy of radiation synovectomy (radiosynovectomy or radiosynoviorthesis) with yttrium-90 in exudative inflammation of synovial membrane of knee joints in patients with rheumatic diseases - preliminary report.
abstract: OBJECTIVE
  Hypertrophic and exudative synovitis of the knee is one of the earliest symptoms in rheumatic diseases. In the case of pharmacotherapy failure, other methods which directly remove the inflamed synovial membrane are used - synovectomies. Radiosynovectomy (RSV) is the radiopharmaceutical application of colloidal solution to joint cavities. In this study, the authors assessed the efficacy of knee radiosynovectomy with yttrium-90 (Y-90) in several groups of patients divided into certain rheumatic diseases.
  
  
  METHODS
  The study group consisted of 70 patients aged from 29 to 65 years with hypertrophic and exudative synovitis of the knee in rheumatic diseases such as rheumatoid arthritis, osteoarthrosis and spondyloarthropathies. Radiopharmaceutical colloid of Y-90, with a radiation dose of 185-222 MBq in a volume of 2-3 ml, was administered to joint. Then the knee joint was immobilized for 72 h. During visits V1, V2, V3 and V4, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured and ultrasound of the knee was performed. Disease activity was evaluated by the WOMAC scale, HAQ and 100-mm visual analog scale (VAS).
  
  
  RESULTS
  The most significant difference of synovial hypertrophy, before and after the procedure, was obtained in patients with rheumatoid arthritis. Variability of effusion before and after the procedure in all groups was comparable and statistically significant. The greatest improvement in variability of inflammatory parameters, before and 4 weeks after radiosynovectomy, was observed in patients with rheumatoid arthritis.
  
  
  CONCLUSIONS
  In the therapeutic algorithm radiosynovectomy should be located between conservative treatment and operative procedures. Radiosynovectomy does not require hospitalization or prolonged rehabilitation. Radiosynoviorthesis affects the patient's general condition, which is associated with eliminating pain and restoring joint function.
authors.affiliation: Department of Rheumatology and Connective Tissue Diseases, J. Biziel University Hospital No. 2, Bydgoszcz, Ludwik Rydygier, Collegium Medicum in Bydgoszcz, UMK in Torun, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Zalewska
authors.affiliation: Department of Rheumatology and Connective Tissue Diseases, J. Biziel University Hospital No. 2, Bydgoszcz, Ludwik Rydygier, Collegium Medicum in Bydgoszcz, UMK in Torun, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Węgierska
authors.affiliation: Department of Rheumatology and Connective Tissue Diseases, J. Biziel University Hospital No. 2, Bydgoszcz, Ludwik Rydygier, Collegium Medicum in Bydgoszcz, UMK in Torun, Poland.
authors.forename: Tacjana
authors.initials: T
authors.lastname: Barczyńska
authors.affiliation: Centre for Clinical Trials, Warsaw, Poland.
authors.forename: Marzena
authors.initials: M
authors.lastname: Waszczak
authors.affiliation: Independent Section of Scientific Research Coordination, J. Biziel University Hospital No. 2, Bydgoszcz, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Żuchowski
authors.affiliation: Department of Rheumatology and Connective Tissue Diseases, J. Biziel University Hospital No. 2, Bydgoszcz, Ludwik Rydygier, Collegium Medicum in Bydgoszcz, UMK in Torun, Poland.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Jeka
keywords: hypertrophic-exudative synovitis; knee; radiosynovectomy