Radiosynoviorthesis of medium-sized joints with rhenium-186-sulphide colloid: a review of the literature

• Published in: Rheumatology Vol. 46; no. 10; pp. 1531 - 1537
• Main Authors: Klett, R., Lange, U., Haas, H., Voth, M., Pinkert, J.
• Format: Journal Article Book Review
• Language: English
• Published: Oxford Oxford University Press 01.10.2007; Oxford Publishing Limited (England)
• Subjects: Arthritis, Rheumatoid - radiotherapy; Biological and medical sciences; Diseases of the osteoarticular system; Haemophilia; Hemarthrosis - radiotherapy; Hematologic and hematopoietic diseases; Humans; Inflammatory joint diseases; Medical sciences; Osteoarthritis; Platelet diseases and coagulopathies; Radioisotopes - adverse effects; Radioisotopes - therapeutic use; Radiosynoviorthesis; Rhenium - adverse effects; Rhenium - therapeutic use; Rhenium-186; Rheumatoid arthritis; Spondylarthropathies - radiotherapy; Spondyloarthropathy; Sulfur - adverse effects; Sulfur - therapeutic use; Synovitis - etiology; Synovitis - radiotherapy; Haemophilia; Spondyloarthropathy; Radiosynoviorthesis; Osteoarthritis; Rhenium-186; Rheumatoid arthritis; Diseases of the osteoarticular system; Autoimmune disease; Hemopathy; Inflammatory joint disease; Review; Wrist; Spondylarthropathy; Ankle joint; Shoulder; Hemophilia; Degenerative disease; Rhenium; Elbow; Human; Immunopathology; Rheumatology; Joint; Synoviorthesis; Hip; Genetic disease; Ankle; Symptomatology; Anatomic pathology; Chronic; Treatment; Arthropathy; Coagulopathy; Bibliographic review
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/kem155

Hypertrophy and inflammation of the synovium with various underlying pathologies—such as rheumatoid arthritis, osteoarthritis, haemophilia and spondyloarthropathy—can be treated successfully by radiosynoviorthesis (RSO). For medium-sized joints (shoulder, elbow, wrist, hip and ankle), the radionuclide of choice is rhenium-186. We review the evidence for the efficacy of this local, relatively non-invasive therapy and evaluate its benefits and risks. We conclude good evidence of rhenium-186 RSO in rheumatoid arthritis and haemophilic arthropathy. In the remaining pathologies, up to now, the therapeutic efficacy has not been confirmed by today's most stringent criteria for clinical studies. The available data support rhenium-186 RSO as a suitable second-line treatment for patients in whom other therapies (including locally injected corticoids) have failed, as long as proper attention is paid to correct administration—including post-treatment immobilization and the co-administration of corticoids.