Beta burns following radionuclide synovectomy

Chojnowski, Marek; Płazińska, Maria Teresa; Chojnowski, Marek Sławomir; Królicki, Leszek

doi:10.5114/reum.2018.76905

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…In local complications after RS skin necrosis, hardto-heal ulcerations and post-radiation dermatitis were described [28][29][30]. It is worth underlining that in the applied procedure, after administration of the radioisotope, the 2 ml needle was flushed with a 1-2% ligno-caine solution; none of our patients experienced local complications Long-term observations indicate the safety of this treatment method in adults.…”

Section: Discussionmentioning

confidence: 55%

The use of radiosynovectomy in patients with juvenile idiopathic arthritis. Assessment of treatment efficacy and safety

Gazda¹,

Ćwikła²,

Kołodziejczyk³

et al. 2021

Reumatologia

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Objectives: The aim of the study was to evaluate the usefulness of knee joint radiosynovectomy (RS) in patients suffering from juvenile idiopathic arthritis (JIA). Material and methods: One hundred RS procedures performed in 58 patients with JIA in average age 10.4 years were evaluated. Results: After 6 weeks, a decrease in the number of cases with joint pain from 90.3% to 29%, with joint oedema from 100% to 74.5%, with joint exudate from 100% to 60.6%, with gait disorders from 19.4% to 3.2%, with joint mobility disorders from 51.1% to 26.6% in the RS cases was observed. A reduction of the score in the Colorado scale from 10.9 to 4.66, in the pain visual analogue scale (VAS) from 50 to 10, in the illness VAS assessed by the patient/parent from 69.9 to 32.4, in the illness VAS assessed by the physician from 68.8 to 36.9 was observed. Six months after the RS procedure, a reduction in the number of cases with joint pain from 89.5% prior to the procedure to 29.5%, with oedema from 100% to 58.3%, with exudate from 100% to 46.9%, with gait disorders from 20% to 2.1%, with joint motility disorders from 51.1% to 26.1% was achieved. The score in the Colorado scale was reduced from 10.9 to 4.04, in the pain VAS from 40 to 0, in the illness VAS assessed by the patient/parent from 69.7 to 27.9, in the illness VAS assessed by the physician from 68.8 to 32.4. In ultrasound examinations, the greatest improvement compared to the initial condition was recorded in the 6 th month after the RS. Radiosynovectomy was positively evaluated by parents and patients in 34 anonymous surveys. Early and late observations (average 1473 days) did not show lesions at the isotope injection site, and no neoplastic lesions were observed. Conclusions: Radiosynovectomy is a valuable therapeutic option for local treatment in patients with JIA.

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Section: Discussionmentioning

confidence: 55%

The use of radiosynovectomy in patients with juvenile idiopathic arthritis. Assessment of treatment efficacy and safety

Gazda¹,

Ćwikła²,

Kołodziejczyk³

et al. 2021

Reumatologia

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“…This is of great importance, since the radioisotope leakage can lead to the most serious complication of RSV: radiation-induced soft tissue necrosis. None of the patients exhibited symptoms of paraarticular soft tissue damage such as skin necrosis, or milder reactions such as beta burns [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Radiosynovectomy of the hip joint – preliminary experience

Chojnowski,

Owczarczak,

Płazińska

et al. 2023

Reumatologia

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IntroductionRadiosynovectomy (RSV) is a minimally invasive method of treating and controlling joint inflammation refractory to conventional pharmacotherapy. It consist in intraarticular injection of radioactive colloids which irradiate the inflamed synovial membrane to cause its subsequent involution. Despite the fact that the hip joint involvement is quite common in systemic inflammatory arthropathies, hip joint RSVs are rarely performed. The aim of this paper is to assess safety and efficacy of hip joint radioisotope treatment.Material and methodsWe retrospectively analyzed the effects of 21 hip joints RSVs performed in 14 patients (10 female, 4 male; aged 8 to 79; mean age 48 years). Before the RSV, all the patients underwent clinical and ultrasound examination. The RSVs were performed using rhenium-186 sulphide under ultrasound guidance. Each patient underwent post-therapeutic scintigraphy to assess intraarticular distribution of the radiopharmaceutical. The effects of the treatment were assessed clinically and ultrasonographically during at least 2 follow-up visits 3 and 6 months after the RSV.ResultsIn 9 cases, we observed complete resolution of symptoms 3 and 6 months after the RSV. Four patients had only a partial response and required repeated treatment, and all responded well to second RSV. In four patients the treatment had no significant effect, and no repeated treatment attempt was made. All the responders suffered from inflammatory arthropathies; the non-responders had osteoarthritis, with no history of systemic diseases. In all the patients, no significant adverse effects were observed, in particular no radiation burns or infections. All post-therapeutic scintigrams showed proper, intraarticular distribution of the radiopharmaceutical.ConclusionsRadiosynovectomy of the hip joint in systemic joint diseases, especially performed using ultrasound-guidance, is a safe and effective treatment modality.

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“…[ 90 Y] yttrium is the most potent radionuclide to induce tissue damage, possibly even full-thickness skin necrosis [170]. Beta radiation burns after [ 186 Re]rhenium colloid are much more limited, usually self-healing within 3-4 weeks, but in severe cases, hyperbaric oxygen treatment is helpful [171][172][173]. [ 169 Er]erbium colloid, with its low energy and small tissue penetration, is unlikely to cause more profound necrosis, and beta radiation burns associated with its use require only conservative treatment [3].…”

Section: Radiation Tissue Damagementioning

confidence: 99%

The EANM guideline for radiosynoviorthesis

Kampen¹,

Boddenberg-Pätzold

Fischer³

et al. 2021

Eur J Nucl Med Mol Imaging

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Purpose Radiosynoviorthesis (RSO) using the intraarticular application of beta-particle emitting radiocolloids has for decades been used for the local treatment of inflammatory joint diseases. The injected radiopharmaceuticals are phagocytized by the superficial macrophages of the synovial membrane, resulting in sclerosis and fibrosis of the formerly inflamed tissue, finally leading to reduced joint effusion and alleviation of joint pain. Methods The European Association of Nuclear Medicine (EANM) has written and approved these guidelines in tight collaboration with an international team of clinical experts, including rheumatologists. Besides clinical and procedural aspects, different national legislative issues, dosimetric considerations, possible complications, and side effects are addressed. Conclusion These guidelines will assist nuclear medicine physicians in performing radiosynoviorthesis. Since there are differences regarding the radiopharmaceuticals approved for RSO and the official indications between several European countries, this guideline can only give a framework that must be adopted individually.

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Beta burns following radionuclide synovectomy

Cited by 6 publications

References 12 publications

The use of radiosynovectomy in patients with juvenile idiopathic arthritis. Assessment of treatment efficacy and safety

The use of radiosynovectomy in patients with juvenile idiopathic arthritis. Assessment of treatment efficacy and safety

Radiosynovectomy of the hip joint – preliminary experience

The EANM guideline for radiosynoviorthesis

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