Current role for radioisotope synovectomy

Joint Bone Spine. 2018 May;85(3):295-299. doi: 10.1016/j.jbspin.2017.06.002. Epub 2017 Jun 23.

Abstract

Radioisotope synovectomy has been extensively used to treat patients with chronic inflammatory joint disease but has moved to a less prominent position since the introduction of new and highly effective drugs. Remaining indications are refractory synovitis, pigmented villonodular synovitis as an adjunct to surgery, and hemophilic arthropathy. The three main radioisotopes used are yttrium-90, rhenium-186, and erbium-189. Radioisotope synovectomy should be performed only by highly experienced professionals, to minimize the risk of injection-related complications. The available safety data, in particular regarding the risk of malignancy, are reassuring. The efficacy of yttrium-90 in chronic inflammatory joint disease remains controversial.

Keywords: Chronic inflammatory joint disease; Hemophilia; Pigmented villonodular synovitis; Radioisotope synovectomy.

Publication types

  • Review

MeSH terms

  • Arthritis / pathology
  • Arthritis / radiotherapy*
  • Brachytherapy / methods
  • Chronic Disease
  • Female
  • Humans
  • Injections, Intra-Articular
  • Male
  • Prognosis
  • Radioisotopes*
  • Rhenium
  • Risk Assessment
  • Severity of Illness Index
  • Synovectomy / methods*
  • Synovitis, Pigmented Villonodular / pathology
  • Synovitis, Pigmented Villonodular / surgery*
  • Treatment Outcome
  • Yttrium Radioisotopes

Substances

  • Radioisotopes
  • Rhenium-186
  • Yttrium Radioisotopes
  • Yttrium-90
  • Rhenium