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Rheumatology Advance Access published online on June 27, 2007
Rheumatology, doi:10.1093/rheumatology/kem155
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Review

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

R. Klett, U. Lange1, H. Haas2, M. Voth3 and J. Pinkert4

Department of Nuclear Medicine, University Hospital Giessen and Marburg GmbH, Giessen, Germany, 1Kerckhoff-Hospital, Department of Rheumatology, Bad Nauheim, 2Hospital association Bonn, Department of Orthopedics and Surgery, Bonn, 3Bayer Schering Pharma, Berlin and 4Schering Deutschland GmbH, Berlin, Germany

Correspondence to: Rigobert Klett, Department of Nuclear Medicine, University Hospital Giessen and Marburg, Friedrichstraße 25, 35385 Giessen, Germany. E-mail: rigobert.klett{at}radiol.med.uni-giessen.de


  Abstract

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.

KEY WORDS: Radiosynoviorthesis, Rhenium-186, Rheumatoid arthritis, Osteoarthritis, Haemophilia, Spondyloarthropathy

Submitted 12 February 2007; revised version accepted 4 May 2007.
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