Radiosynovectomy is an established therapy in arthritis and involves an intra-articular injection of small radioactive particles to treat synovitis (inflammation of the lining of a joint cavity). Frequent indications are rheumatoid arthritis, other inflammatory joint diseases, haemophilic arthritis, and pigmented villonodular synovitis (PVNS).
For rheumatoid arthritis, visit conditions write-up at https://www.sgh.com.sg/patient-care/conditions-treatments/rheumatoid-arthritis/symptoms
For haemophilia, visit conditions write-up at https://www.sgh.com.sg/patient-care/conditions-treatments/bleeding-tendency
Patients considered for radiosynovectomy will have failed at least one intra-articular injection of long-acting steroid. Pain will usually be severe enough to limit normal activities and/or require regular analgesics. X-rays of the joints to be treated should be obtained. Additional imaging procedures include bone scan (3-phase of the affected joints) and MRI.
X-rays of the joints to be treated should be obtained.
Additional imaging procedures include bone scan (3-phase of the affected joints) and MRI.
Informed written consent must be obtained.
About 60-80% of patients benefit from radiosynovectomy. Response is unlikely within 14 days of injection and may be delayed until up to 1 month. There is a risk of a temporary increase in synovitis following treatment.
Radiosynovectomy will not benefit other non-treated joints.
For female patients, please ensure that you are not pregnant, as the radiation from radiosynvectomy may be harmful to the developing fetus during pregnancy. Please inform your doctor if you are breast feeding.
The treated joint should be immobilised for 2 days. As far as practicable, the patient should not weight-bear on the treated joint for the same duration, although partial weight-bearing may be allowed for practical reasons.
Following treatment, patients should avoid pregnancy for at least 4 months.
During the first 2 days post-treatment, patients are advised to observe rigorous hygiene to avoid urinary contamination.
