Abstract
Radiosynovectomy (RSV) is a local intra-articular injection of radionuclides in colloidal form for radiotherapy. RSV relieves pain and inflammation from rheumatoid arthritis (RA), for which it initially was used, and is accepted as an alternative to surgical synovectomy. Clinical history of the patient and disability of the joint are not enough to decide RSV and a dedicated interdisciplinary team (e.g., hematology, rheumatologist, orthopedic surgeon, and nuclear medicine physician) consisting of referring physician should be necessary to consider RSV application. Reported success rates range from 40% to 90% for the different joints and underlying diseases. RSV should be considered the initial therapeutic option for the treatment of patients with hemophilic hemarthrosis. RSV injections should be performed under fluoroscopy or ultrasonography examination with appropriate size needle and preferred approach according target joint anatomy.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Fellinger K, Schmid J. Local therapy of rheumatic diseases. Wiener Zeitschrift fur innere Medizin und ihre Grenzgebiete. 1952;33(9):351.
Kampen W, Boddenberg-Pätzold B, Fischer M, Gabriel M, Klett R, Konijnenberg M, Kresnik E, Lellouche H, Paycha F, Terslev L. The EANM guideline for radiosynoviorthesis. Eur J Nucl Med Mol Imaging. 2021;1
Ingrand J. Characteristics of radio-isotopes for intra-articular therapy. Ann Rheum Dis. 1973;32(Suppl):3.
Bowring C, Keeling D. Absorbed radiation dose in radiation synovectomy. Br J Radiol. 1978;51(610):836.
Knut L. Radiosynovectomy in the therapeutic management of arthritis. World J Nucl Med. 2015;14(01):10.
Kresnik E, Mikosch P, Gallowitsch H, Jesenko R, Just H, Kogler D, Gasser J, Heinisch M, Unterweger O, Kumnig G. Clinical outcome of radiosynoviorthesis: a meta-analysis including 2190 treated joints. Nucl Med Commun. 2002;23(7):683.
Schneider P, Farahati J, Reiners C. Radiosynovectomy in rheumatology, orthopedics, and hemophilia. J Nucl Med. 2005;46(1 suppl):48S.
Pirich C, Schwameis E, Bernecker P, Radauer M, Friedl M, Lang S, Kritz H, Wanivenhaus A, Trattnig S, Sinzinger H. Influence of radiation synovectomy on articular cartilage, synovial thickness and enhancement as evidenced by MRI in patients with chronic synovitis. J Nucl Med. 1999;40(8):1277.
Takase-Minegishi K, Horita N, Kobayashi K, Yoshimi R, Kirino Y, Ohno S, Kaneko T, Nakajima H, Wakefield RJ, Emery P. Diagnostic test accuracy of ultrasound for synovitis in rheumatoid arthritis: systematic review and meta-analysis. Rheumatology. 2018;57(1):49.
Sandrock D, Backhaus M, Burmester G, Munz D, Rheumatologie fdKBVdDGf. Imaging techniques in rheumatology: scintigraphy in rheumatoid arthritis. Z Rheumatol. 2003;62:476.
Stollfuss JC, Freudenberg LS, Wieder H. 99mTc-DPD SPECT/CT for localisation of inflammatory and chronic osteoarthritis of the foot and ankle. Nuklearmedizin-NuclearMedicine. 2016;55(04):145.
Franssen M, Koenders E, Boerbooms AT, Buijs W, Lemmens J, Van De Putte L. Does application of radiographic contrast medium in radiation synovectomy influence the stability of Yttrium-90 colloid? British Journal of Rheumatology. 1997;36(04);506.
Myasoedova E, Crowson CS, Kremers HM, Therneau TM, Gabriel SE. Is the incidence of rheumatoid arthritis rising?: results from Olmsted County, Minnesota, 1955–2007. Arthritis Rheum. 2010;62(6):1576.
Hunter TM, Boytsov NN, Zhang X, Schroeder K, Michaud K, Araujo AB. Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004–2014. Rheumatol Int. 2017;37:1551.
Fraenkel L, Bathon JM, England BR, St. Clair EW, Arayssi T, Carandang K, Deane KD, Genovese M, Huston KK, Kerr G. 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2021;73(7):1108.
Liepe K. Efficacy of radiosynovectomy in rheumatoid arthritis. Rheumatol Int. 2012;32(10):3219.
Srivastava A, Santagostino E, Dougall A, Kitchen S, Sutherland M, Pipe SW, Carcao M, Mahlangu J, Ragni MV, Windyga J. WFH guidelines for the management of hemophilia. Haemophilia. 2020;26:1.
Wyseure T, Mosnier LO, von Drygalski A. Advances and challenges in hemophilic arthropathy. In: Seminars in hematology. Elsevier; 2016. p. 10.
van Vulpen LF, Thomas S, Keny SA, Mohanty SS. Synovitis and synovectomy in haemophilia. Haemophilia. 2021;27:96.
Haberman B. S2k-Leitlinie Synovitis bei Hämophilie 2018. Gesellschaft für Thrombose-und Hämostaseforschung e V(GTH).
Walsh DA, McWilliams DF, Turley MJ, Dixon MR, Fransès RE, Mapp PI, Wilson D. Angiogenesis and nerve growth factor at the osteochondral junction in rheumatoid arthritis and osteoarthritis. Rheumatology. 1852;49(10):2010.
Rodriguez-Merchan EC, Heim M, Wallny T. The hemophilic joints. J Blood Disord Transfus. 2011;2(3):111.
Szentesi M, Nagy Z, Géher P, Papp I, Kampen WU. A prospective observational study on the long-term results of 90 yttrium citrate radiosynoviorthesis of synovitis in osteoarthritis of the knee joint. Eur J Nucl Med Mol Imaging. 2019;46:1633.
Van der Zant F, Jahangier Z, Moolenburgh J, Swen W, Boer R, Jacobs J. Clinical effect of radiation synovectomy of the upper extremity joints: a randomised, double-blind, placebo-controlled study. Eur J Nucl Med Mol Imaging. 2007;34:212.
Szerb I, Gál T, Kiss D, Nagy V, Hangody L. Efficacy assessment of radiosynoviorthesis on the progression of radiological osteoarthritic features of hip and ankle joint in patients with osteoarthritis and rheumatoid arthritis. Nuklearmedizin-NuclearMedicine. 2020;59(03):269.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Dikmen, G., Ozden, V.E., Karaytug, K. (2024). Radiosynovectomy. In: Kocaoglu, B., Laver, L., Girolamo, L.d., Compagnoni, R. (eds) Musculoskeletal Injections Manual. Springer, Cham. https://doi.org/10.1007/978-3-031-52603-9_10
Download citation
DOI: https://doi.org/10.1007/978-3-031-52603-9_10
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-52602-2
Online ISBN: 978-3-031-52603-9
eBook Packages: MedicineMedicine (R0)