Safety of Radiosynovectomy in Hemophilic Synovitis: it is Time to Re‐evaluate!

Review Article

Safety of Radiosynovectomy in Hemophilic Synovitis: it is Time to Re‐evaluate!

Cuneyt Turkmen

Affiliation: Department of Nuclear Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

Submission date: 2nd July 2009, Revision date: 11th August 2009, Acceptance date: 18th August 2009


ABSTRACT

The hemophiliac joint has become an increasing target for radiosynovectomy since the first description by Ahlberg in 1977. Radiosynovectomy with the beta‐emitting nuclide has been effective in dramatically reducing the frequency of hemarthroses and resolving chronic synovitis in hemophilic patients. Because the joint‐surface erosions secondary to chronic synovitis often occur in early childhood and progress to advanced arthropathy by late adolescence, these patients need therapy in the early stages of life. However, several issues, including radiopharmaceutical choice and the potential side‐effects, have been questioned, particularly in younger patients concerning radiation safety. Although the clinicians have been a bit confused about the safety of radiosynovectomy in the pediatric population, recent advances have prompted clinicians to take a renewed interest in the potential side‐effects of radiosynovectomy. There is a growing realization that the benefits of properly performed radiosynovectomy should always outweigh any short‐ or long‐term side‐effects.

Keywords: radiosynovectomy, radiosynoviorthesis, safety, hemophilia, synovitis, yttrium, rhenium
Correspondence: Cuneyt  Turkmen, Istanbul University, Istanbul Faculty of Medicine, Department of Nuclear Medicine, Çapa, 34390 Istanbul, Turkey