Indications For Reradiosynoviorthesis

In cases of minor treatment response after the first radionuclide injection, retreat-ment is possible and may result in increased clinical benefit for the patient. Rera-diosynoviorthesis is especially helpful in joints with initially highly thickened synovia, in joints with large and/or quickly recurrent effusion, and in finger or toe joints, in which only a portion of the radionuclide is given owing to an insufficient joint volume. Reradiosynoviorthesis is recommended not sooner than six months after the first treatment. In patients with recurrent effusion as the primary symptom, often seen in postarthroplasty synovitis of the knee, retreatment as early as three months after the first radionuclide therapy has been shown to be efficacious in our patients, as we observed no major improvement after three months in this subset of patients so far. Two failed radionuclide treatments should not be followed by another attempt of radiation synovectomy. Repeated treatment however seems justified in patients, suffering from a relapse, in whom the preceding radiation synovectomy had resulted in clinical improvement which lasted for several years. In case of reradiosynoviorthesis, the same activities and conditions apply as described for normal first-time procedures.

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