Treatment Monitoring And Patient Followup

After radionuclide injection, a distribution scan should be acquired with a gamma camera (except for Er-169) to document successful intra-articular injection and proper distribution within the joint.

For the follow-up which is usually performed by the referring physician in close collaboration with the nuclear medicine specialist, no standard guidelines

Table 7 Treatment Monitoring and Patient Follow-Up

An early check-up for side effects or other complications is recommended at four to seven days after treatment; this might be done by phone as well Clinical follow-up examinations to assess treatment response are recommended

3-4, 6, and 12 months after therapy Reradiosynoviorthesis should not be scheduled sooner than six months after the first therapy; treatment of other joints can be performed anytime exist (Table 7). It is recommended to observe for early side effects or complications at four to seven days after treatment. Furthermore, patients should be advised to report any worsening or other uncommon changes in the treated joint, and the patient should be given a contact that he can reach at any time. Owing to intense effusion it might become necessary to puncture a treated joint. Within the first two to four weeks, joint punctures should be performed in the nuclear medicine department in order to properly handle and store the contaminated fluid in accordance with national radiation safety regulations.

Clinical follow-up examinations to assess treatment response are recommended 3, 6, and 12 months after radiation synovectomy. Reradiosynoviorth-esis should not be scheduled sooner than six months after the first therapy.

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