Radiosynovectomy for the treatment of rheumatoid arthritis of the elbow

The Aim of this retrospective study was to evaluate the efficiacy of radios ynovectomy (RSO) in patients with rheumatoid elbow arthritis. Patients and Methods. 40 joints of 31 patients were evaluated. At the time of therapy, p atients had been suffering from elbow arthritis for 17.5 months (2-72 month s). 95% of the joints (n = 38) had severe daily pain or continuous pain, 97 .5% (n = 39) had moderate to severe limitation of the mobility and 10% (n = 4) had severe swelling. RSO was performed by intraarticular injection of 7 4 MBq colloidal rhenium-1 86 and 15 mg triamcinolonehexocetonide. Before an d six to 26 months after therapy (median follow-up 14.7 months) severity of the patients pain, mobility and swelling (transferred to a scoring system) were determined with a standardised questionaire. A clinical re-evaluation , along with an arthrosonographical follow-up was performed in 28 joints. R esults: A "good to very good" overall long-term response was achieved in 80 % (n = 32) of the treated joints and a temporary response in 10% (n = 4). O nly 10% (n = 4) had a non-satisfactory response due to advanced articular d estruction. The range of motion for flexion-extension increased from 103.8 +/- 20.0 degrees to 144.0 +/- 12.8 degrees (p < 0.001). The respective scor es for articular pain, impaired mobility and swelling decreased significant ly (pain from 3.15 to 0.82, impaired mobility from 3.15 to 0.82, swelling f rom 2.40 to 0.65; p <0.001). No deterioration or complication occurred. The effects lasted throughout the entire followup time for 36 joints (90%). Co nclusion: For patients with rheumatoid involvement of the elbow joint, radi osynovectomy results in a significant decrease of articular pain and improv ement of objective parameter, i.e. joint mobility. Thus, radiosynovectomy r epresents a feasible and effective therapeutic option for elbow arthritis.