Radiosynoviorthesis in the treatment of chronic arthritis

The effectiveness of radiosynoviorthesis in the local treatment of chronica lly inflammatory joint diseases, especially rheumatoid arthritis, was evalu ated. Subjects and methods: Follow-up examinations of 415 joints in 115 patients up to 4.5 years after intraarticular application of beta-emitting yttrium-9 0, rhenium-186, and erbium-169 were evaluated. The examination protocol inc luded estimation of joint circumference, range of active joint moving capab ility, fist-bending power, and radiological assessment of joint destruction . Subjective assessment of pain, swelling, and joint function by the patien ts was evaluated by means of a score with three levels. Results: The mean range of active joint moving capability increased in all joint subgroups, compared with the initial examination, with exception of a nkle joints examined more than 30 months after therapy. The mean joint circ umference decreased in all joint subgroups. Good to excellent results were achieved in up to 66% of joints, satisfying results in up to 21%, and no im provement or further deterioration was noted in 13% according to subjective assessment by patients themselves. Treatment proved most effective in join ts with poor or no alteration in X-ray examinations. Conclusion: In the local treatment of chronically inflammatory joint diseas es - especially beyond systemic drug therapy and local corticoid therapy -, radiosynoviorthesis is a low-invasive method, which may provide long-term relief of pain and swelling as well as improvement of joint function.