Radiosynovectomy in the Therapeutic Management of Arthritis
| Autor: | Liepe Knut |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
Clotting factor musculoskeletal diseases rheumatoid arthritis medicine.medical_specialty Erbium-169 hemophilic arthritis business.industry Joint replacement lcsh:R895-920 medicine.medical_treatment Arthritis Synovectomy Osteoarthritis Review Article medicine.disease Hemophilic Arthritis Surgery osteoarthritis rhenium-186 Synovitis Rheumatoid arthritis medicine yttrium-90 business |
| Zdroj: | World Journal of Nuclear Medicine World Journal of Nuclear Medicine, Vol 14, Iss 1, Pp 10-15 (2015) |
| ISSN: | 1607-3312 1450-1147 |
| Popis: | Radiosynovectomy is a well-established therapy in arthritis and involves an intra-articular injection of small radioactive particles to treat a synovitis. In Europe, frequent indications are rheumatoid and poly-arthritis. Especially in Germany radiosynovectomy is the second common therapy in Nuclear Medicine with about 40,000-60,000 treated joints per year. In Spain, USA, Turkey, Argentines and Philippines the therapy is more use in hemophilic arthritis with excellent results. Especially in developing countries with low availability of clotting factors, the radiosynovectomy represent a cost effective therapeutic option for repeated bleedings in hemophilic arthropathy. The special focus in these countries is maintaining of mobility and work ability. Often only the knee and medium joints (ankle, elbow and shoulder) are treated using yttrium-90, rhenium-186 or phosphorus-32. However, in rheumatoid arthritis most common affected joints are the fingers. For the treatment in these small joints, erbium-169 is necessary. Unfortunately, erbium-169 is only available in Europe. Further indications for radiosynovectomy are osteoarthritis and the articular effusion after joint replacement. The reported response rates in rheumatoid and poly-arthritis range from 60% to 80% depends from the stage of previous arthrosis. The best effectiveness of therapy was observed in hemophilic arthritis with response rate of 90% and significant reducing of bleeding frequency. The therapy is well-tolerated with low rate of side effects. In respect of the specific uptake of particles in the synovia and short range of beta radiation, the radiation exposure outside the joint is very low. The radiosynovectomy has efforts in comparison to surgical synovectomy: it′s a minor intervention with low costs; and simultaneous treatments of multiple joints or treatment in short intervals are possible. The presented paper summarized the published papers and reports our own experiences in >15,000 treated joints. |
| Databáze: | OpenAIRE |
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