Radiation protection aspects of radiation synovectomy procedures

Mono-arthritis may be a presenting feature for a variety of inflammatory arthopathies such as those associated with rheumatoid arthritis or psoriatic arthritis. Such patients can be troubled by a single persistently inflamed and swollen joint when other involved joints have improved in response to systemic therapy (eg methotrexate). Such persisting synovitis, involving excess growth of the synovial tissue within the knee, contributes to an ongoing inflammatory process. This can lead to excess synovial fluid and progression of structural damage, reducing mobility and contributing to ongoing pain and swelling. Patients usually undergo surgery but if symptoms persist, a radiosynovectomy (also referred to as a radiosynoviorthesis) can be considered.

A radiosynovectomy involves a rheumatologist placing a needle within the synovial cavity. They then aspirate the synovial fluid from the knee using the syringe. Following this, 185MBq of Yttrium-90 silicate/citrate is injected, followed by a local anaesthetic and a steroid solution.

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