Radiosynovectomy

Radiosynovectomy

Radiosynovectomy, also known as synoviorthesis, derives from the Greek words "synovia" (referring to the synovium) and "orthosis" (meaning restoration). This implies the restoration of the synovial membrane of the joint through the application of local radioactive irradiation. In the field of nuclear medicine, this therapeutic method has been effectively utilized for the treatment of chronic inflammatory joint diseases.

Operating principle

With the help of an intra-articular injection of a radionuclide, the inflamed synovial membrane is irradiated, its superficial hypertrophied layers are destroyed without damage to the cartilage tissue. Irradiation is largely limited to the synovial membrane area, since the radionuclides used emit radiation with a maximum range of a few millimeters. Used in colloidal form, the radionuclide is phagocytized by superficial synovial cells, where it leads to a reaction to radiation in the form of necrosis, followed by fibrosis and sclerosis of the synovial membrane, with a decrease in proliferation and inflammation of the synovial membrane.

Indications for radiosynovectomy :

Radiosynovectomy is indicated for chronic synovitis with recurrent intra-articular effusions in the following conditions:

• rheumatoid arthritis
• seronegative spondyloarthropathies
• arthritis with inflammation
• arthropathies with crystal deposits (eg, gout)
• villonodular (villonodular) synovitis
• arthropathy in hemophilia
• following arthroscopic synovectomy

How is the therapy performed?

The procedure of radiosynovectomy is conducted on an outpatient basis at the clinic. After thorough disinfection of the skin and local anesthesia, the joint is punctured, and then a radioactive substance is injected into the joint cavity. After this procedure, the joint must remain immobile for 48 hours, and to achieve this, the joint is fixed with a splint. Following this period, it is recommended to avoid stressing the joint for another week.