title: Short-term clinico-radiological outcome of chronic knee synovitis among haemophilia A patients post phosphorus-32 radiosynoviorthesis.
abstract: Various modes of therapy have been directed at breaking the vicious cycle at early stage of synovitis in haemophilia patients. This study was planned to assess the short-term clinico-radiological outcome of chronic knee synovitis among haemophilia A patients post phosphorus-32 (P-32) radiosynoviorthesis.
  
  
  
  P-32 samarium radiocolloid was injected into the knee and patients were followed up at 1 and 3 months, respectively. Clinical outcomes was assessed using Tegner Lysholm scores (TLSs), Modified Knee Society Clinical Rating System (MKSS) score and circumference of the knee joint. The radiological outcomes were assessed using X-ray, ultrasonography and bone scan.
  
  
  
  Among the fifteen haemophilia A patients studied, there was statistically significant difference in TLS ( χ2(2) = 27.887 and p value < 0.001), MKSS scores ( χ2(2) = 27.745 and p < 0.001) and circumference of the knee joint ( χ2(2) = 21.333 and p < 0.001) at preoperatively, 1- and 3-month follow-up. There were no changes noted in follow-up X-rays compared with the preoperative X-ray. Ultrasonography showed that clinical improvement was more in suprapatellar and medial parapatellar regions in the last 2 months compared to the first month of follow-up. Post P-32 bone scan showed marked decrease in uptake in the affected knee joint suggestive of radio ablation of synovial tissue.
  
  
  
  P-32 radiosynoviorthesis done for chronic synovitis among haemophilia A patients showed significant improvement in both clinical and radiological parameters. Ultrasonography can be utilized as non-invasive radiological modality for follow-up of P32 response for knee joint.
authors.affiliation: 1 Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Prasanna
authors.initials: P
authors.lastname: Ty
authors.affiliation: 1 Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Jagadish
authors.initials: J
authors.lastname: Menon
authors.affiliation: 2 Department of Orthopaedics, ESIC-MC & PGIMSR, Rajajinagar, Bengaluru, India.
authors.forename: Nataraj
authors.initials: N
authors.lastname: Ar
authors.affiliation: 3 Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Dhanapathi
authors.initials: D
authors.lastname: Halanaik
authors.affiliation: 4 Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Harshith
authors.initials: H
authors.lastname: Kramadhari
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint; D008297:Male; D010761:Phosphorus Radioisotopes / Q000627:therapeutic use*; D013585:Synovitis / Q000175:diagnosis / Q000209:etiology* / Q000532:radiotherapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010761:Phosphorus Radioisotopes; C000615311:Phosphorus-32
keywords: Modified Knee society clinical Rating System score; Tegner Lysholm score; phosphorus-32 samarium; radiosynoviorthesis