Long-term results of radiation synovectomy: a clinical follow-up study

Radiation synovectomy by intra-articular injection of p-emitting radionucli des is a reliable and easy-to-perform therapy without harmful side effects for the treatment of inflammatory rheumatoid as well as degenerative joint diseases. The indication for radiation synovectomy is based on both clinica l symptoms and on proven hyperperfusion, with active synovitis being seen o n a pre-therapeutic three-phase bone scan. In this study, the clinical resp onse after 6-18 months, evaluated by a standardized questionnaire, was comp ared with the reduction of synovitis seen on three-phase bone scintigraphy after treatment of 475 joints in 151 patients. The best clinical results we re obtained in cases of true rheumatoid arthritis (73.4%), with less in oth er kinds of arthritis (48.8%) such as psoriatic or reactive arthritis. Beca use of the inflamed synovium being the main target tissue, clinical results in osteoarthritis with severe bone destruction are poorer (33.9%). However , synovitis can be markedly reduced (in approximately 70%), regardless of t he underlying diagnosis, as shown by post-therapeutic three-phase bone scan ning. Radiation synovectomy can be recommended in all kinds of arthritis. I t should also be considered in cases of osteoarthritis as a last therapeuti c option prior to joint replacement. ((C) 2001 Lippincott Williams & Wilkin s).