AB1366 Radioisotopic synoviorthesis in the control of refractory synovitis in castilla-la mancha (A REGION OF SPAIN). an experience of 10 years
Authors: D. Castro Corredor
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Our hospital is the reference hospital in Nuclear Medicine for the realisation of radioisotopic synoviorthesis for all of Castilla-La Mancha (a region of Spain). <h3>Objectives</h3> To describe the experience in the performance of radioisotopic synoviorthesis in arthritis refractory to other treatments in our hospital. <h3>Methods</h3> Observational, descriptive and cross-sectional study protocolised through the review of the database of radioisotopic synoviorthesis performed between 2007 and 2017. Previous clinical data were collected (age, sex, pathology, previous treatments, previous infiltration and affected joint) and evolutive at 6 months after administering the isotope. An Excel database was created for a frequency analysis with SPSS 21. <h3>Results</h3> 30 radiosynovitis were performed with the most frequent pathologies, in this order: pigmented villonodular synovitis (40%), rheumatoid arthritis (23.3%), spondyloarthritis (13.3%), osteoarthritis (10%) and nonspecific arthritis (6.7%), followed by systemic lupus erythematosus and gout. After 6 months, 56.7% of patients improved compared to 36.7% who remained the same. Likewise, none of them presented complications related to the procedure. A 6.6% of patients were lost to follow-up. <h3>Conclusions</h3> In patients with episodes of recurrent arthritis with associated joint effusion in one or two joints, refractory to systemic treatments, to local infiltrations with corticosteroids and in those patients in whom other treatments may be contraindicated, we must consider the possibility of performing an isotope radiosinoviortesis, as it is a simple, safe technique with a success rate of more than 50%. <h3>References</h3> [1] Delbarre f, Caylaf, Menkes C. La synoviorthese par les radioisotopes. Presse Med1968; 76:1045 [2] J. Román Ivorra, J. Chismol Abad, M. Morales Suárez Varela, M. Ureña, J. Ribes Iborra, R. Sopena Monforte. La sinoviortesis radioisotópica en la artritis reumatoide. Estudio de 108 casos. Revista Española de Medicina Nuclear. 2000;19(4):275–278. [3] Taylor W, Corkill M, Rajapaske C. A retrospective review of yttrium-90 synovectomy in the treatment of knee arthritis. Br J Rheumatol1997; 36:1100- 1105. [4] Harbert C. Radiocolloid joint therapy in joint diseases. In Habert JC. Edition. Nuclear medicine therapy. New York. Thieme Medical; 1987:169–186. [5] Stevenson AC, Bedford J, Hill AGS, Hill H. Chromosome damage in patients who have had intraarticular injections of radioactive gold. Lancet1937b; 2:837839. [6] Román J, Chismol J, Morales M, Ureña M, Ribes J, Sopena R. La sinoviortesis radioisotópica en la artritis reumatoide. Estudio de 108 casos. Rev Esp Med Nucl2000; 19:275–278. [7] Siegel M, Siegel H, Luck J. Radiosynovectomy's clinical applications and cost effectiveness: A review. Sem Nucl Med1997;27:364–371. [8] Mulero J. Sinovectomía quirúrgica y sinovectomía isotópica. Med Clin (Barc)1985; 85:835–837. [9] Jones G. Yttrium synovectomy: a meta-analysis of the literature. Aust NZ J Med1993; 23:272–275. [10] Heuft-Dorenbosch L, de Vet H, van der Linden S. Yttrium radiosynoviorthesis in the treatment of knee arthritis in rheumatoid arthritis: a systematic review. Ann Rheum Dis2000;59:583–586. <h3>Disclosure of Interest</h3> None declared