Radiosynoviorthesis - Frequently asked questions

What does radiosynoviorthesis mean?

Radiosynoviorthesis is a method of nuclear medical therapy which has proved successful for many years in treating chronically inflammatory joint diseases. Translated literally, radiosynoviorthesis means the restoration of the synovial membrane by means of radiation.

What happens in a chronically inflamed joint?

Chronically inflammatory joint diseases are the result of a permanent inflammation of the synovium, which swells and frequently proliferates like villi. There are various causes and triggers for the inflammation. When the inflammation is permanent, in time other important elements of the joint, such as cartilage and bone, are damaged (secondary arthrosis).

When is radiosynoviorthesis appropriate and which joints can be treated?

All joints on the extremities can be treated with RSO. Proven indications are all rheumatic joint diseases (as a rule only after at least 6 months basic therapy which was not sufficiently successful), activated arthroses and chronic synovialitis following joint replacement with recurring effusion from the joint.
Three-phase bone scintigraphy or magnetic resonance imaging with contrast agent is as a rule required to clarify matters.

How is the therapy performed?

Following thorough disinfection of the skin and a local anaesthetic, the joint is punctured under sterile conditions. The correct positioning of the needle is checked and documented by injecting a small amount of contrast agent.
A slightly radioactive substance is then injected, different radionuclides and doses being used for different joints.

A distribution scintigraphy is then performed to document that the substance was properly distributed in the joint.

Finally a sterile bandage and a splint are applied.

What must be borne in mind after radiosynoviorthesis?

After the therapy the joints should not be moved for 48 hours. To ensure this, the joints are immobilised with a sterile bandage and a splint. When joints of the lower extremities are treated, the patient must also be provided with apparatus to enable them to walk. The effect of RSO is felt with a considerable delay (generally 6-12 weeks, sometimes up to 6 months). It very rarely needs to be repeated; a follow-up examination should be conducted after about half a year.

Are there side-effects and how high is the exposure to radiation?

The radionuclides which are injected are so-called beta emitters with a short to very short range. They have an effect on the synovial membrane, but do not damage the healthy tissue, such as cartilage or bone, or other people.