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Intra-articular Treatment of Digital Osteoarthritis by Radiosynoviorthesis—Clinical Outcome in Long-term Follow-up

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Osteoarthritis (OA) is a degenerative joint disease, leading to increasing pain and disability. In digital joints, OA results in a reduced quality of life with significantly restricted daily manual activities.… Click to show full abstract

Osteoarthritis (OA) is a degenerative joint disease, leading to increasing pain and disability. In digital joints, OA results in a reduced quality of life with significantly restricted daily manual activities. Inflammatory processes are increasingly recognized as an important part of OA. Thus, a local anti-inflammatory treatment using intra-articularly applied radiocolloids can be used for treatment. Purpose This retrospective study analyzed the long-term effects of radiosynoviorthesis (RSO) with special emphasis to local joint pain in patients from 4 different RSO centers in Germany and Austria. Methods A total of 168 finger joints in 147 patients with digital joint OA were investigated. The indication for RSO was based on both clinical complaints and a proven synovitis, despite anti-inflammatory pharmacotherapy and previous intra-articular corticosteroid injections. Radiosynoviorthesis was performed according to international guidelines. A numeric visual analog scale (VAS) before and after treatment was used to measure the outcome. Follow-up was done for at least 2 years after treatment, in some patients even over 10 years. Results Radiosynoviorthesis resulted in a significant reduction of VAS values in most of the patients, lasting for the whole period of follow-up. Two-thirds of the treated joints showed clinically relevant improvement, if a reduction of 30% in VAS values was defined as a reasonable cutoff. The best results were achieved in thumb base joints. Conclusions This article confirms that RSO is a suitable treatment option for digital joint OA with a proven synovitis. The analgesic effect is long-lasting and comparable to the success of RSO in patients with rheumatoid arthritis.

Keywords: radiosynoviorthesis; long term; outcome; intra articular; treatment

Journal Title: Clinical Nuclear Medicine
Year Published: 2022

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