This book presents a systematic survey of different local treatments in inflammatory joint diseases and their potential side effects and complications. Both surgical therapies and pharmaceutical strategies involving local or systemic application of anti-inflammatory and immunomodulating drugs are addressed. Special emphasis is placed on nuclear medicine therapy by intra-articular instillation of beta radiation emitters, known as radiosynoviorthesis or radiation synovectomy. Possible complications, in particular radionecrosis, infection, and thromboembolism, are described and available treatment strategies are examined in detail. In addition, radiation safety considerations are critically reviewed and relevant clinical questions are discussed.
While radiosynoviorthesis is an effective and safe treatment if a proper indication is secured and if the application is performed by an experienced nuclear medicine physician, local complications can never be excluded with certainty. This book will support physicians who are engaged in the care and treatment of patients with inflammatory joint disease, approximately 30,000 of whom undergo radiosynoviorthesis in Europe each year.
Preface.- Histopathology of synovitis.- Non-radioactive treatmentof synovitis (risk-benefit).- Introduction to radiosynoviorthesis (RSO).- Dosimetry and radiation burden.- Local complications and possible treatment strategies.- Risk of malignoma induction.- Baker's cysts – a relevant contraindication?.-Analysis of periodic update reports.- Summary.