Side Effects And Dosimetric Considerations

Side effects of radiation synovectomy are related to local complications, which arise from para-articular injection and intra-articular infection (Table 6). They may also be related to radiation exposure during the normal treatment course such as a transient radiogenic synovitis, potential radiation damage to articular cartilage or subchondral bone, and irradiation of locoregional lymph nodes, liver, and spleen owing to extra-articular leakage of the radiocolloids.

Other side effects may arise from allergic reactions to the contrast medium or local anesthetics, thrombosis as a result of immobilization, or flush symptoms or hyperglycemia in diabetic patients owing to systemic resorption of the intra-articularly applied steroids. In diabetic patients, the dose of intra-articular steroids may be reduced, and the patients should be instructed to regularly check their blood glucose levels for the next two days. In patients with a history of thrombosis or other disorders with an increased risk of blood clotting, antithrombotic measures are recommended and the patients should be carefully instructed to watch for any signs of thrombosis after treatment and immobilization of joints of the lower limbs.

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